国际妇产科学杂志

国际妇产科学杂志 ›› 2013, Vol. 40 ›› Issue (3): 271-273.

• 论著 • 上一篇    下一篇

高磷酸化胰岛素样生长因子结合蛋白-1联合宫颈指数预测早产

王欢华，王晨虹   

  1. 518028 广东省深圳市，南方医科大学附属深圳妇幼保健院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-06-15 发布日期:2013-06-15

The Value of Insulin-Like Growth Factor Bingding Protein-1 and Cervical Index in the Prediction of the Diagnosis-Delivery Interval for Premature Delivery

WANG Huan-hua，WANG Chen-hong   

  1. Maternal and Child Care Hospital of Shenzhen Affiliated to South Medical University，Shenzhen 518028，Guangdong Province，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-06-15 Online:2013-06-15

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摘要： 目的：探讨高磷酸化胰岛素样生长因子结合蛋白-1（phosphorylated insulin-like growth factor binding protein-1，phIGFBP-1）联合宫颈指数对早产分娩时间的预测价值。方法：188例先兆早产妊娠妇女，应用单克隆抗体检测宫颈分泌物中phIGFBP-1，同时经会阴超声检测宫颈指数，按照检测结果分为两指标阳性组、两指标之一阳性组、两指标阴性组，随访至分娩，比较各组患者距离分娩时间（the diagnosis-to-delivery interval，DDI）。结果：两指标阳性组DDI明显短于单一指标阳性组及两指标阴性组（P＜0.05）。联合应用两指标对1周内分娩预测敏感度、特异度、阳性预测值和阴性预测值分别为100.0%（33/33）、30.3%（47/155）、65.0%（26/40）和100.0%（47/47）。两指标阳性组中宫颈指数大于0.8者，1周内分娩率为100.0%（14/14），48 h内分娩率为85.7%（12/14）。两指标阴性组中2周内分娩的阴性预测值为100%（47/47）。结论：宫颈分泌物phIGFBP-1联合宫颈指数有望成为预测早产分娩时间的客观指标而应用于临床。

关键词: 胰岛素样生长因子结合蛋白-1, 子宫颈, 早产, 预测, 超声检查

Abstract: Objective：To assess the efficacy of cervical phosphorylated insulin-like growth factor binding protein-1（phIGFBP-1） in combination with cervical index measurement for the prediction of the diagnosis-delivery interval（DDI） for preterm delivery. Methods：A total of 188 threatened premature delivery women complaining with uterine contractions were recruited in this study，who received cervical swabs for phIGFBP-1 detection and transperineal ultrasound scan to assess cervical index. According to these results，all the patients are divided into three groups：double-positive group，one-positive group， double-negative group，they were followed until delivery. An analysis of the DDI between groups was carried out. Results：The DDI of double-positive group was shorter than that of double-negative group and one-positive group（P＜0.05）. When combining the two methods in forecasting DDI within one week，the values of the sensitivity，specificity，the positive predictive value and the negative predictive value were 100.0%（33/33），30.3%（47/155），65.0%（26/40），100.0%（47/47） respectively. In double-positive group，all the patients deliveried within one week and 85.7% of them deliveried within 48 hours when their cervical index were more than 0.8. The negative predictive value of double-negative group for delivery within two weeks was 100%（47/47）. Conclusions：The combination of cervical phIGFBP-1 and cervical index measurement may serve as an objective indication for the prediction of the DDI for premature delivery，and as a guide for clinical treatment.

Key words: Insulin-like growth factor binding protein-1, Uterine cervix, Premature delivery, Forcasting, Ultrasonography