中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
1期
103-105
,共3页
刘蓓%张力%石俊贞%李琳%瞿梅
劉蓓%張力%石俊貞%李琳%瞿梅
류배%장력%석준정%리림%구매
促肾上腺激素释放激素%胎儿纤维连接蛋白%宫颈长度%早产
促腎上腺激素釋放激素%胎兒纖維連接蛋白%宮頸長度%早產
촉신상선격소석방격소%태인섬유련접단백%궁경장도%조산
Corticotropin releasing hormone%Fetal fibronectin%Cervical length%Preterm labor
目的 探讨孕妇血浆促肾上腺皮质激素释放激素(CRH)及阴道分泌物中胎儿纤维连接蛋白(fFN)检测联合宫颈长度测量对预测早产的临床价值.方法 采集2009年12月至2010年12月来我院查体孕妇的血浆及阴道分泌物,应用ELISA方法检测CRH和fFN,观察其在妊娠不同时间的变化,并结合不同妊娠结局(早产与足月产)进行分析.结果 112例孕妇早产54例,足月产58例.早产组妊娠24周时宫颈管长度为(2.8±0.4) cm,足月产组为(3.3±0.5) cm,差异有统计学意义(t=3.254,P=0.021).早产组与足月产组妊娠28～ 30周、31 ～32周、33 ～34周、35 ～36周血浆CRH分别为(162.33±16.49)、(60.01±14.56) ng/L,( 352.12±61.01)、(118.04±53.74) ng/L,(364.55±56.71)、(122.95±71.41) ng/L,(372.78±149.89)、(124.00±19.05)ng/L,差异均有统计学意义(t值分别为3.687、6.875、8.652、8.524,P均＜0.05).CRH、fFN联合宫颈长度测定预测早产均有较好的灵敏度(97.92％)、特异度(90.00％)、阳性预测值(95.92％)和阴性预测值(94.73％).结论 检测孕妇CRH、ffN联合宫颈长度测量可以提高对早产的预测性,为早产的早期诊断与治疗提供良好、可靠的临床依据.
目的 探討孕婦血漿促腎上腺皮質激素釋放激素(CRH)及陰道分泌物中胎兒纖維連接蛋白(fFN)檢測聯閤宮頸長度測量對預測早產的臨床價值.方法 採集2009年12月至2010年12月來我院查體孕婦的血漿及陰道分泌物,應用ELISA方法檢測CRH和fFN,觀察其在妊娠不同時間的變化,併結閤不同妊娠結跼(早產與足月產)進行分析.結果 112例孕婦早產54例,足月產58例.早產組妊娠24週時宮頸管長度為(2.8±0.4) cm,足月產組為(3.3±0.5) cm,差異有統計學意義(t=3.254,P=0.021).早產組與足月產組妊娠28～ 30週、31 ～32週、33 ～34週、35 ～36週血漿CRH分彆為(162.33±16.49)、(60.01±14.56) ng/L,( 352.12±61.01)、(118.04±53.74) ng/L,(364.55±56.71)、(122.95±71.41) ng/L,(372.78±149.89)、(124.00±19.05)ng/L,差異均有統計學意義(t值分彆為3.687、6.875、8.652、8.524,P均＜0.05).CRH、fFN聯閤宮頸長度測定預測早產均有較好的靈敏度(97.92％)、特異度(90.00％)、暘性預測值(95.92％)和陰性預測值(94.73％).結論 檢測孕婦CRH、ffN聯閤宮頸長度測量可以提高對早產的預測性,為早產的早期診斷與治療提供良好、可靠的臨床依據.
목적 탐토잉부혈장촉신상선피질격소석방격소(CRH)급음도분비물중태인섬유련접단백(fFN)검측연합궁경장도측량대예측조산적림상개치.방법 채집2009년12월지2010년12월래아원사체잉부적혈장급음도분비물,응용ELISA방법검측CRH화fFN,관찰기재임신불동시간적변화,병결합불동임신결국(조산여족월산)진행분석.결과 112례잉부조산54례,족월산58례.조산조임신24주시궁경관장도위(2.8±0.4) cm,족월산조위(3.3±0.5) cm,차이유통계학의의(t=3.254,P=0.021).조산조여족월산조임신28～ 30주、31 ～32주、33 ～34주、35 ～36주혈장CRH분별위(162.33±16.49)、(60.01±14.56) ng/L,( 352.12±61.01)、(118.04±53.74) ng/L,(364.55±56.71)、(122.95±71.41) ng/L,(372.78±149.89)、(124.00±19.05)ng/L,차이균유통계학의의(t치분별위3.687、6.875、8.652、8.524,P균＜0.05).CRH、fFN연합궁경장도측정예측조산균유교호적령민도(97.92％)、특이도(90.00％)、양성예측치(95.92％)화음성예측치(94.73％).결론 검측잉부CRH、ffN연합궁경장도측량가이제고대조산적예측성,위조산적조기진단여치료제공량호、가고적림상의거.
Objective To study the value of plasma corticotropin-releasing hormone (CRH) and the fetal fibronectin (fFN) in vaginal secretions and cervical length in predicting preterm labor.Methods The plasma CRH levels and fFN levels in vaginal secretions from 24 -37 weeks pregnant woman checked up in our hospital from Dec.2009 to Dec.2010 were detected by ELLISA method.The changes of these three indexes were observed with the pregnant time and were analyzed according to different pregnancy outcomes.Results Among the 112 cases of pregnant women,premature delivery in 54 cases,full-term birth 58 cases.At the 24 week of pregnancy,there were significant difference on the cervical length( [2.8 ±0.4]cm vs [3.3 ±0.5]cm,t =3.254,P =0.021 ) between premature delivery group and full-term birth group.At the 28 - 30 week,31 -32 week,33 - 34 week,35 - 36 week,the CRH were ( 162.33 ± 16.49 ) ng/L,(60.01:±: 14.56) ng/L;(352.12 ±61.01 )ng/L,( 118.04 ±53.74)ng/L; (364.55 ±56.71 )ng/L,( 122.95 ±71.41 )ng/L; (372.78 ±149.89)ng/L,(124.00 ± 19.05 )ng/L respectively in premature delivery group and full-term birth group,and there were significant differences on CRH at the four different pregnant time(t =3.687,6.875,8.652,8.524,respectively,P ＜ 0.05 ).It shows better sensitivity ( 97.92％ ),specificity ( 90.00％ ),positive predictive value(95.92％ ) and negative predictive value(94.73％ ) in predicting premature delivery by detection of CRH,fFN combined with cervical length.Conclusion Detection of plasma CRH,fFN combined with cervix length measurement can improve the predictability of premature and provide a good,reliable clinical basis for the early diagnosis and treatment for preterm premature.
