phIGFBP-1与宫颈长度对早产的预测

目的探究高磷酸化胰岛素样生长因子结合蛋白-1(phIGFBP-1)与宫颈长度对早产预测价值。方法选取2013年6月至2014年12月在湖州师范学院附属第一医院妇产科收治的96例孕周为28~37周早产高危孕妇,按照妊娠结局分为早产组(32例),足月产组(64例)。对两组研究对象宫颈黏液phIGFBP-1表达情况、宫颈长度进行比较,分析其对早产的诊断价值。结果早产组孕妇宫颈黏液中phIGFBP-1阳性率显著高于足月产组,差异具有统计学意义(x^2=9.874,P=0.002)。phICFBP-1阳性组孕妇28~32周内分娩率显著高于phIGFBP-1阴性组,差异具有统计学意义(x^2=7.513,P=0.006)。phIGFBP-1阳性组孕妇33~37周内分娩率显著高于phIGFBP-1阴性组,差异具有统计学意义(x^2=12.300,P=0.001)。早产组28~32周、33~37周宫颈长度均显著低于足月产组,差异具有统计学意义(t值分别为5.154、4.145,均P<0.015)。使用孕妇宫颈黏液中phIGFBP-1联合宫颈长度诊断早产阳性预测值(67.7%)、准确率(78.1%)均高于单独使用phIGFBP-1、宫颈长度诊断。结论 phIGFBP-1、宫颈长度可作为早产预测指标,联合诊断可以提高早产的阳性预测值和诊断的正确性。

Comparison of PAMG-1 and phIGFBP-1 Tests for the Prediction of Preterm Delivery in Patients with Preterm Labor

Objective: To compare PAMG-1 and phIGFBP-1 tests in predicting impending spontaneous preterm delivery within 7 days upon presentation in pregnant women with symptoms of preterm labor. Study Design: From September 2014 to April 2015 women with singleton gestation, symptoms of preterm labor, GA 22 - 35, participated in this prospective cohort study upon admission. Recruited patients had intact membranes and a minimal cervical dilatation of ≤3 cm. Vaginal swabs for phIGFBP-1 and PAMG-1 were taken in addition to routine treatment. Biochemical test results were blinded and had no effect on management of patients. Results: A total of 96 patients were screened for inclusion into the trial;57 met the inclusion criteria for final analysis. The PAMG-1 test was positive in 5.7% of patients, while phIGFBP-1 test was positive in 29.8% of patients. The prediction of spontaneous preterm delivery within 7 days of admission in patients with a cervical length Conclusion: Our study supports the high negative predictability of biochemical tests to rule out spontaneous preterm labor in patients with a short cervix. However, our study strongly suggests that the PAMG-1 test is more accurate for predicting imminent spontaneous preterm delivery as compared to phIGFBP-1. These findings can significantly reduce economic burden caused by unnecessary admission and treatment of patients suspected of preterm labor. Such a reduction in the use of corticosteroids and tocolytics would lead to a reduction in the short and long term health effects associated with the use of therapeutic drugs like corticosteroids, antibiotics and tocolytics.

宫颈长度联合高磷酸化胰岛素样生长因子结合蛋白-1预测早产的价值

目的探讨超声检查宫颈长度联合检测早产孕妇宫颈分泌物中高磷酸化胰岛素样生长因子结合蛋白-1(phIGFBP-1)对预测早产的价值。方法选取我院2011年1月至2012年12月,孕28～36周孕妇106例。采用分娩预测试剂盒检测孕妇宫颈分泌物中phIGFBP-1,并联合B超测量计算宫颈指数。按照分娩情况分为早产组和足月组,对数据进行记录并作出比较与分析。结果 106例孕妇妊娠分娩结果为早产组24例,足月组82例;测量平均宫颈长度,早产组为(3.51±0.59)cm,足月组为(4.21±0.89)cm。将宫颈长度≤4.0cm作为指标和临界点,在phIGFBP-1的阳性率中早产组占50%(13/26),足月分娩组占50%(13/26)。二者联合预测的结果为早产敏感性为54.2%;早产特异度值为100%;阳性预测值为100%;阴性预测值为85.7%。结论以孕妇宫颈分泌物中phIGFBP-1检测为阳性且检查宫颈长度≤4.0cm为指标可以提高早产预测的准确性。

宫颈胰岛素样生长因子－1联合宫颈超声检查预测早产临床应用研究

目的：探讨检测磷酸化胰岛素样生长因子结合蛋白－1（ phIGFBP－1）联合宫颈指数对早产分娩时间的预测价值。方法先兆早产孕妇160例，进行单一检测宫颈phIGFBP－1、阴道B超测量计算宫颈指数预测早产及两者联合预测早产，比较分娩结局及距离分娩的时间。结果两指标联合预测早产明显优于单一指标预测，且两指标阳性组距离分娩时间明显短于单一指标阳性组及两指标阴性组（P＜0．05）。两指标联合应用对1周内分娩预测的敏感度、特异度、阳性预测值和阴性预测值分别为100％（31／31）、27．9％（36／129）、63．2％（24／38）、100％（36／36）。两指标阳性组中宫颈指数大于0．8者，1周内分娩率为100％，两指标阴性组中1周内分娩的阴性预测值为100％。结论 phIGFBP－1检测联合宫颈指数测定可作为预测早产的客观指标，方法简便易行。

高磷酸化胰岛素样生长因子结合蛋白-1联合宫颈长度预测早产

目的：探讨检测早产高危孕妇宫颈分泌物中高磷酸化胰岛素样生长因子结合蛋白-1（phIGFBP-1）、腹部超声检查宫颈长度预测早产的价值。方法：孕24-34周用分娩预测试纸检测宫颈分泌物中phIGFBP-1（Actim Partus test）,同时腹部超声检测宫颈长度（cervical length,CL）,观察记录分娩结局。结果：早产组phIGFBP-1阳性率38.89%（7/18）,足月产组phIGFBP-1阳性率10.61%（7/66）,两组比较差异有统计学意义（P〈0.01）。根据受试者工作特性曲线（ROC曲线）,CL≤4.0 cm为最佳参考值。以CL≤4.0 cm为临界点,结合宫颈分泌物phIGFBP-1,预测早产的敏感性38.89%（7/18）、特异性66.67%（44/66）、阳性预测值58.33%（7/12）、阴性预测值91.67%（44/48）。结论：孕妇宫颈分泌物phIGFBP-1阳性、CL≤4.0 cm是预测早产发生的敏感、可靠指标。