中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
12期
2284-2288
,共5页
蔡坚%李玉洁%陈汉青%张颖%杨建波
蔡堅%李玉潔%陳漢青%張穎%楊建波
채견%리옥길%진한청%장영%양건파
细胞黏附分子%宫颈长度测量%早产%宫内感染
細胞黏附分子%宮頸長度測量%早產%宮內感染
세포점부분자%궁경장도측량%조산%궁내감염
Cell adhesion molecules%Cervical length measurement%Premature birth%Interuterine infection
目的：探讨可溶性细胞间黏附分子-1（sICAM-1）含量与孕妇妊娠结局的相关性，及其在先兆早产及晚期先兆流产诊治中的意义。方法2011年4月至2012年3月在中山大学附属第一医院产科规律产检并分娩单胎妊娠共73例，分为正常对照组32例，晚期先兆流产及先兆早产41例，其中足月分娩组24例，早产组17例。采用酶联免疫吸附法测定血清sICAM-1，比较组间血清sICAM-1含量差异及其与孕妇早产的关系。结果（1）早产组sICAM-1浓度高于正常对照组及足月分娩组，早产组宫颈长度小于足月分娩组。（2）sICAM-1浓度、宫颈长度分别达到388.65 ng/ml、21.5 mm时，预测先兆早产及晚期先兆流产孕妇早产的敏感性、特异性、阳性预测值、阴性预测值分别为52.9%、95.7%、90.0%、74.2%，58.8%、91.7%、83.3%、75.9%。（3）以sICAM-1＝388.65 ng/ml及宫颈长度21.5 mm为临界点，联合预测晚期先兆流产及先兆早产孕妇早产的敏感性、特异性、阳性预测值、阴性预测值分别为35.3%、87.5%、100%及84%。结论（1）sICAM-1达到388.65 ng/ml时可预测先兆早产及晚期先兆流产孕妇早产的发生。（2）以sICAM-1＝388.65 ng/ml及宫颈长度21.5 mm为临界点，两者联合预测晚期先兆流产及先兆早产孕妇早产可提高阳性预测值及阴性预测值。
目的：探討可溶性細胞間黏附分子-1（sICAM-1）含量與孕婦妊娠結跼的相關性，及其在先兆早產及晚期先兆流產診治中的意義。方法2011年4月至2012年3月在中山大學附屬第一醫院產科規律產檢併分娩單胎妊娠共73例，分為正常對照組32例，晚期先兆流產及先兆早產41例，其中足月分娩組24例，早產組17例。採用酶聯免疫吸附法測定血清sICAM-1，比較組間血清sICAM-1含量差異及其與孕婦早產的關繫。結果（1）早產組sICAM-1濃度高于正常對照組及足月分娩組，早產組宮頸長度小于足月分娩組。（2）sICAM-1濃度、宮頸長度分彆達到388.65 ng/ml、21.5 mm時，預測先兆早產及晚期先兆流產孕婦早產的敏感性、特異性、暘性預測值、陰性預測值分彆為52.9%、95.7%、90.0%、74.2%，58.8%、91.7%、83.3%、75.9%。（3）以sICAM-1＝388.65 ng/ml及宮頸長度21.5 mm為臨界點，聯閤預測晚期先兆流產及先兆早產孕婦早產的敏感性、特異性、暘性預測值、陰性預測值分彆為35.3%、87.5%、100%及84%。結論（1）sICAM-1達到388.65 ng/ml時可預測先兆早產及晚期先兆流產孕婦早產的髮生。（2）以sICAM-1＝388.65 ng/ml及宮頸長度21.5 mm為臨界點，兩者聯閤預測晚期先兆流產及先兆早產孕婦早產可提高暘性預測值及陰性預測值。
목적：탐토가용성세포간점부분자-1（sICAM-1）함량여잉부임신결국적상관성，급기재선조조산급만기선조유산진치중적의의。방법2011년4월지2012년3월재중산대학부속제일의원산과규률산검병분면단태임신공73례，분위정상대조조32례，만기선조유산급선조조산41례，기중족월분면조24례，조산조17례。채용매련면역흡부법측정혈청sICAM-1，비교조간혈청sICAM-1함량차이급기여잉부조산적관계。결과（1）조산조sICAM-1농도고우정상대조조급족월분면조，조산조궁경장도소우족월분면조。（2）sICAM-1농도、궁경장도분별체도388.65 ng/ml、21.5 mm시，예측선조조산급만기선조유산잉부조산적민감성、특이성、양성예측치、음성예측치분별위52.9%、95.7%、90.0%、74.2%，58.8%、91.7%、83.3%、75.9%。（3）이sICAM-1＝388.65 ng/ml급궁경장도21.5 mm위림계점，연합예측만기선조유산급선조조산잉부조산적민감성、특이성、양성예측치、음성예측치분별위35.3%、87.5%、100%급84%。결론（1）sICAM-1체도388.65 ng/ml시가예측선조조산급만기선조유산잉부조산적발생。（2）이sICAM-1＝388.65 ng/ml급궁경장도21.5 mm위림계점，량자연합예측만기선조유산급선조조산잉부조산가제고양성예측치급음성예측치。
ObjectiveTo analyze the relationship between serum soluble intercellular adhesion molecule-1(sICAM-1) and preterm labor and to determine whether sICAM-1 can be an medical index for prediction and treatment.Methods73 nulliparous women, including 32 normal term delivery cases, 24 term labor cases with threatened labor in the second/third trimester and 17 preterm labor cases were recruited who received regular prenatal care and delivered at the first affiliated hospital of Sun yat-sen University. Serum sICAM-1 levels were assessed by enzyme-linked immunoassay(ELISA) to compare difference of sICAM-1 levels among groups and analyze the relevance between sICAM-1 and preterm delivery.Results In women with preterm delivery, serum sICAM-1 concentrations were significantly higher andcervical lengths were significantly shorter compared with women experiencing term labor and normal pregnancy, (345.56±33.93)ng/mlvs. (255.42±18.84)ng/ml,P=0.010; (345.56±33.93)ng/mlvs. (231.78±17.32)ng/ml,P=0.001; When cut-off of sICAM-1 was 388.65 ng/ml, cervical length was 21.5 mm or combined, the sensitivity, specificity, positive and negative predictive value to predict preterm delivery were 52.9%, 95.7%, 90.0%, 74.2%; 58.8%, 91.7%, 83.3%, 75.9% 35.3%, 87.5%, 100%, 84% respectively.ConclusionsWhen sICAM-1 is 388.65 ng/ml or cervical length is 21.5 mm, it can predict preterm delivery. Combinating sICAM-1 with cervical length to predict preterm delivery can improve positive and negative predictive value.
