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。

Prediction of premature delivery by cervical length and phosphorylated insulin-like growth factor- binding protein- 1

Objective:To explore the significance of cervical length and phosphorylated insulin-like growth factor-binding protein-1 in predicting premature delivery in high risk gravidity.Methods:Cervical length was measured by transabdominal sonography and a rapid strip test was performed to detect phIGFBP-1 in cervical secretions from 24 to 34 weeks.Results:The positive rate of phIGFBP-1 in preterm labor group and term birth group was respectively 38.89%(7/18)and 10.61%(7/66).There were statistically significant differences between the two groups(P<0.01).According to ROC curve,4.0cm or less of the cervical length seemed to be the most suitable compromise.The sensitivity,the specificity,the positive predictive value and negative predictive value was 38.89%,66.67%,58.33%,91.67%,respectively by combined application of cervical length and phIGFBP-1.Conclusion:Cervical length and phIGFBP-1 can be used as the objective indicators for prediction of preterm labor.