联合筛查在预测早产中的应用研究

目的:探讨联合筛查在早产预测中的应用。方法:检测孕妇宫颈阴道分泌物中胎儿纤连蛋白(fFN)、人绒毛膜促性腺激素(β-HCG)、胰岛素样生长因子结合蛋白1(IGFBP-1)含量以及血清中C反应蛋白(CRP)和白细胞数量(WBC),并利用Herrera模型进行调查。结果:早产组孕妇fFN、β-HCG、IGFBP-1、血CRP、WBC较足月产组均明显上升,差异有统计学意义(P<0.01),且fFN、IGFBP-1及β-HCG 3项指标联合对早产的预测准确度为91.2%,敏感度为91.7%,特异性为90.7%,阳性预测值为89.8%,阴性预测值为92.5%。另外焦虑和社会经济状况差与早产有明显关系。结论:孕妇宫颈阴道分泌物fFN、β-HCG及IGFBP-1联合筛查对早产预测的准确度较高,此外孕妇的焦虑情绪也与早产有关。

Application of combined screening in the prognosis of premature delivery

Objective:To explore the application of combined screening in the prognosis of premature delivery.Methods:The levels of fetal fibronectin(fFN),β-human chorionic gonadotrophin(β-HCG),insulin-like growth factor binding protein-1(IGFBP-1) in cervicovaginal secretion and C reactive protein(CRP) in serum of pregnant women,the amount of leucocytes in serum were detected,the results were surveyed by Herrera model.Results:The levels of fFN,β-HCG,IGFBP-1,CRP and the amount of leucocytes in premature delivery group were higher than those in term delivery group(P<0.01).The prognostic accuracy,sensitivity and specificity of fFN,β-HCG and IGFBP-1 were 91.2%,91.7% and 90.7%,respectively;the positive predictive value was 89.8%;while the negative predictive value was 92.5%.In addition,anxiety and poor socioeconomic situation were associated with premature delivery.Conclusion:The combined screening of fFN,β-HCG and IGFBP-1 in cervicovaginal secretion of pregnant women has high accuracy.Besides,anxiety of pregnant women is related to premature delivery.