宫颈胰岛素样生长因子结合蛋白-1联合宫颈超声测量对预测早产的价值探讨

目的联合应用两种对于早产预测的敏感性、特异性、阳性及阴性预测值均较高的方法，进一步提高早产的预测率，提高对于早产发生时间的预测准确度，对预测阳性者及早进行有效干预，改善围产儿结局。方法符合入组条件的孕妇，取膀胱结石位，常规消毒外阴、窥器暴露宫颈后取宫颈管内分泌物，测定宫颈胰岛素样生长因子结合蛋白-1（IGFBP-1）后再使用GE—E8型彩超经阴道测量宫颈结构，并计算出宫颈指数。结果IGFBP-1阳性对于早产预测的阳性率为65．0％；阴性预测率为89．1％。宫颈指数（〈0．5）对于早产预测的阳性率为60．0％；阴性预测率为91．7％。二者结合对于早产预测的阳性率为90．0％；阴性预测率为96．7％。结论测定宫颈IGFBP-1，并行超声测量宫颈管产度二者联合对于预测早产的发生明显优于单一方法。

Discussion on value of the combination of cervical insulin-like growth factor binding protein-1 with cervical ultrasonic measurement for preterm birth prediction

Objective ] The purpose of this research was to improve the predication rate of preterm birth and the prediction accuracy of the preterm birth time by combining the two methods of high sensibility, specificity, positive and negative predictive values in terms of preterm birth prediction, as well as improve outcomes of the peri-natal infants by providing effective early interruptions for positive peri-natal mothers determined with the two prediction methods. Methods ] As for the pregnant mothers meeting the inclusion criteria, the bladder stone place was taken, regular sterilization was done to the vulvae, the intracervical secreta was taken after exposure of the cervixes with speculum, the transvaginal measurement of the cervical structures with GE-E 8 model color Doppler ultrasound was carried out after the cervical insulin-like growth factor binding protein-1 （IGFBP-1） was measured, and the cervical indexes were calculated. Results ] The positive prediction rate of preterm birth determined with positive IGFBP-1 results was： 65.0%; while the negative rate was： 89.1%. The positive prediction rate of preterm birth determined with cervical index （〈0.5） was： 60.0%; while the negative rate was： 91.7%. The positive prediction rate of preterm birth determined by combination of the above two parameters was： 90.0%; while the negative rate was： 96.7%. Conclusion ] It is superior to the use of single method to combine cervical insulin-like growth factor binding protein-1 measurement and ultrasonic measurement of cervical canal length in the predication of occurrence of preterm birth.