CAJ | 학술논문

目的探讨阴道分泌物胎儿纤维连接蛋白(fFN)与宫颈长度测量联合应用在早产预测中的价值.方法选择2006年12月至2007年12月在北京大学第一医院等四家医院就诊的孕22～35周,有不规律宫缩,或有早产高危因素的511例孕妇为研究对象,检测其宫颈阴道分泌物中fFN,同时B超测量宫颈长度,比较其临产的时间及孕周情况.结果 fFN阳性对7 d内分娩预测的敏感度为77.4%,特异度69.4%,阴性预测值97.9%,对34周内分娩预测的敏感度、特异度和阴性预测值分别为70.5%,70.0%,96.2%.宫颈缩短(≤3 cm)者7 d内分娩的敏感度、特异度、阴性预测值分别为54.8%、66.3%、95.8%;对34周内分娩预测的敏感度、特异度和阴性预测值分别为59.1%、67.2%、和94.6%,二者联合7 d内分娩预测敏感度、特异度、阳性预测值和阴性预测值分别为51.6%、87.1%和96.5%;预测34周内分娩的敏感度45.5%,特异度87.6%,阴性预测值94.5%.结论阴道分泌物fFN比宫颈长度对预测7 d及34周内分娩有较高的阴性预测值及特异度,与超声宫颈长度测量联合应用可进一步提高其阳性预测值和特异度,提高对早产的预测.
목적 탐토음도분비물태인섬유련접단백(fFN)여궁경장도측량연합응용재조산예측중적개치.방법 선택2006년12월지2007년12월재북경대학제일의원등사가의원취진적잉22～35주,유불규률궁축,혹유조산고위인소적511례잉부위연구대상,검측기궁경음도분비물중fFN,동시B초측량궁경장도,비교기임산적시간급잉주정황.결과 fFN양성대7 d내분면예측적민감도위77.4%,특이도69.4%,음성예측치97.9%,대34주내분면예측적민감도、특이도화음성예측치분별위70.5%,70.0%,96.2%.궁경축단(≤3 cm)자7 d내분면적민감도、특이도、음성예측치분별위54.8%、66.3%、95.8%;대34주내분면예측적민감도、특이도화음성예측치분별위59.1%、67.2%、화94.6%,이자연합7 d내분면예측민감도、특이도、양성예측치화음성예측치분별위51.6%、87.1%화96.5%;예측34주내분면적민감도45.5%,특이도87.6%,음성예측치94.5%.결론 음도분비물fFN비궁경장도대예측7 d급34주내분면유교고적음성예측치급특이도,여초성궁경장도측량연합응용가진일보제고기양성예측치화특이도,제고대조산적예측.
Objective To discuss the clinical value of fetal fibronectin (fFN) and cervical length in predicting preterm birth. Methods Totally, 511 pregnant women at 22-35 weeks of gestations were enrolled from Dec. 2006 to Dec. 2007 at 4 tertiary hospitals in Beijing, and all with either symptoms or high risk factors of preterm birth, but without preterm premature rupture of membrane or vaginal bleeding. Cervical fFN were determined and cervical length of each subjects were measured by ultrasound. The pregnancy outcomes were compared. Results The sensitivity, specificity and negative predictive value (NPV) of fFN in predicting preterm birth within 7 d were 77.4%, 69.4% and 97. 9%, respectively; and 70.5%, 70.0% and 96.2% for deliveries within 34 weeks. The above figures changed to 54.8%, 66.3%, 95.8% for deliveries within 7 d and 59.1%, 67.2%, 94.6% for those within 34 weeks, respectively, when cervical length ≤3 cm was applied to predict preterm birth. When fFN and cervical length were combined, the sensitivity, specificity and NPV were 51.6%, 87.1%, 96.5% for deliveries within 7 d, and 45.5%, 87.60/00, 94.5% for those within 34 weeks, respectively. Conclusions FFN has higher NPV and specificity than cervical length in predicting preterm birth within 7 d and 34 weeks, and the positive predictive value and specificity can be improved when combined with cervical length.