孕中、晚期胎儿纤维连接蛋白、人绒毛膜促性腺激素联合孕妇宫颈长度对预测早产儿的价值分析

王晓梅; 秦智娟; 曹璐

doi:10.13898/j.cnki.issn.1000-2200.2021.03.009

孕中、晚期胎儿纤维连接蛋白、人绒毛膜促性腺激素联合孕妇宫颈长度对预测早产儿的价值分析

Analysis of the value of fetal fibronectin, human chorionic gonadotropin combined with maternal cervical length in predicting premature infants in middle and late pregnancy

摘要

摘要:
目的分析孕中、晚期胎儿纤维连接蛋白（fFN）、人绒毛膜促性腺激素（hCG）联合孕妇宫颈长度对预测早产儿的价值。
方法选择具有早产危险因素的孕妇174例作为研究对象，根据是否发生早产分为早产组与对照组。取宫颈阴道分泌物通过胶体金法和酶联免疫吸附法检测fFN和hCG，并采用阴道超声测量宫颈长度，分析单项指标及三项联合指标预测早产儿的价值。
结果174例具有早产危险因素的孕中、晚期孕妇中45例发生早产（25.9%），其中孕28~30周5例，孕31~33周6例，孕34~37周34例，无流产发生；早产组合并妊娠内感染及妊娠内高血压占比均高于对照组（P < 0.05）；阴道液fFN预测早产或足月产的准确率为76.4%（133/174），敏感度75.5%（34/45）和特异度76.7%（99/129），阴道液hCG为69.5%（121/174）、64.4%（29/45）、71.3%（92/129），宫颈长度为80.5%（140/174）、82.2%（37/45）、79.8%（103/129），单项检测中宫颈长度预测具有早产危险因素的孕中、晚期孕妇发生早产的价值最高，阴道液fFN与hCG联合宫颈长度预测早产或足月产的准确率为88.5%（154/174），敏感度91.1%（41/45），特异度87.6%（113/129）。
结论具有早产危险因素的孕中、晚期孕妇可通过宫颈长度测量预测早产，此外阴道液fFN对早产的预测也具有一定的价值，阴道液fFN与hCG联合宫颈长度预测早产准确率最高。

Abstract:
ObjectiveTo analyze the value of fetal fibronectin(fFN), human chorionic gonadotropin(hCG) in combination with cervical length in predicting premature infants in middle and late pregnancy.
MethodsA total of 174 pregnant women with risk factors of preterm delivery were divided into the preterm delivery group and control group according to the occurrence of preterm delivery.The fFN and hCG in cervical and vaginal secretions were detected using colloidal gold assay and enzyme-linked immunosorbent assay, and the cervical length was measured using vaginal ultrasound.The value of single index and three combined indexes in predicting premature infants were analyzed.
ResultsAmong the 174 pregnant women with risk factors of preterm birth, 45(25.9%) cases were born prematurely, which included 5 cases with pregnancy 28-30 weeks, 6 cases with pregancy 31-33 weeks and 34 cases with pregnancy 34-37 weeks, and no abortion occurred.The proportions of infection and hypertension during pregnancy in preterm delivery group were higher than those in control group(P < 0.05).The accuracy, sensitivity and specificity of vaginal fluid fFN predicting premature or full-term delivery were 76.4%(133/174), 75.5%(34/45) and 76.7%(99/129), respectively, the accuracy, sensitivity and specificity of vaginal fluid hCG predicting premature or full-term delivery were 69.5%(121/174), 64.4%(29/45), 71.3%(92/129), respectively, and the accuracy, sensitivity and specificity of the cervical length predicting premature or full-term delivery were 80.5%(140/174), 82.2%(37/45), and 79.8%(103/129), respectively.Among the single test, the value of cervical length was of the highest value in predicting the occurrence of preterm delivery in pregnant women with risk factors for preterm delivery.The accuracy, sensitivity and specificity of the cervical length combined with vaginal fluid fFN and hCG in predicting preterm delivery or full-term delivery were 88.5%(154/174), 91.1%(41/45) and 87.6% (113/129), respectively.
ConclusionsThe cervical length in pregnant women with risk factors for preterm delivery in middle and late pregnancy can predict preterm delivery.In addition, the vaginal fluid fFN also has a certain value for the prediction of preterm delivery.The combination of vaginal fluid fFN, hCG and cervical length has the highest accuracy and significant value in the prediction of preterm delivery.

HTML全文

参考文献(19)

施引文献

资源附件(0)