宫颈低浓度胰岛素样生长因子结合蛋白-Ⅰ对分娩预测的初步研究

Preliminary study of cervical level of insulin-like growth factor binding protein-Ⅰ on prediction of delivery

目的 探讨宫颈分泌物中胰岛素样生长因子结合蛋白 Ⅰ (IGFBP Ⅰ )对分娩预测的作用。方法 对 16 8例妊娠 37～ 4 2周、未临产、胎膜完整的孕妇 ,采用免疫层析法进行宫颈分泌物IGFBP Ⅰ测定。结果 宫颈分泌物中IGFBP Ⅰ预测 3d内分娩的敏感性、特异性、阳性预测值和阴性预测值分别为 76 .6 1%、77.2 7%、90 .4 8%和 5 3.97%。预测 7d内分娩的敏感性、特异性、阳性预测值和阴性预测值分别为 72 .0 0 %、95 .83%、99.0 5 %和 36 .5 0 %。与宫颈Bishop评分比较 ,有较高的预测价值。 结论 宫颈分泌物IGFBP Ⅰ可以反映宫颈成熟度及子宫下段的生理变化过程 ,且不依赖于临床经验 ,对于指导临床进行必要的产科处理具有实际意义。

Objective To appraise the effect of phosphorylation of insulin-like growth factor binding protein-Ⅰ(IGFBP-Ⅰ) in cervical discharge for prediction of delivery. Method 168 unparturient pregnant women of 37～42 gestation weeks ,with intact fetal membranes were enrolled in this study. The IGFBP-Ⅰ in cervical discharge was determined by immunochromatography. Results Within three days before delivery, the sensitivity, specificity, positive predictive value and negative predictive value of IGFBP-Ⅰ in the cervical discharge for prediction of delivery were 76.61%, 77.27%, 90.48% and 53.97%, respectively. The above four parameters were 72.00%, 95.83%, 99.05% and 36.50% within seven days before delivery. The results showed that IGFBP-Ⅰ in the cervical discharge had higher prediction value for delivery than the Bishop score. Conclusion IGFBP-Ⅰ in the cervical discharge reflects cervical maturation and the change of physiological process of the the lower uterine segment, independent on clinical experience but with practical clinical significance in obstetrical management.