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。

Diagnostic value for predicting premature delivery by phIGFBP-1 and cervical length

Objective To investigate the diagnostic value for predicting premature delivery by high phosphorylation insulin-like growth factor binding protein 1 (phIGFBP-1) and cervical length.Methods From June 2013 to December 201496 high-risk pregnancy women at gestational 28-37 weeks admitted in department of gynecology and obstetrics were selected from the First Affiliated Hospital of Huzhou Teachers College, and they were divided into preterm group (32 cases) and full-term group (64 cases) according to pregnancy outcomes. Results Positive rate of phIGFBP-1 in the cervical mucus of preterm group was significantly higher than that of full-term group (χ2 =9.874, P=0.002).Compared with phIGFBP-1 negative group, delivery rate during gestational 28-32 weeks was significantly higher and that during gestational 33 -37 weeks was also remarkably higher in phIGFBP-1 positive group of preterm cases (χ2 value was 7.513 and 12.300, respectively, and P value was 0.006 and 0.001, respectively).The cervical length of cases at gestational 28-32 weeks and 33-37 weeks of preterm group was significantly shorter than that of full-term group (t value was 5.154 and 4.145, respectively, both P<0.05).Joint use of phIGFBP-1 in cervical mucus and cervical length in diagnosis of premature delivery had higher predictive value (67.7%) and accuracy (78.1%) than single phIGFBP-1 or cervical length.Conclusion PhIGFBP-1 and cervical length can be used as indexes to predict premature delivery, and joint diagnosis can improve the positive predictive value and accuracy.