CAJ | 학술논문

目的：探讨超声宫颈长度（CL）检测联合宫颈分泌物胎儿纤维连接蛋白（fFN）检测在早产预测中的临床价值。方法对2011年1月至2013年1月期间收治的120例先兆早产孕妇分别进行超声 CL 检测和宫颈分泌物 fFN检测，比较两种方式分别单独检测和联合检测预测早产敏感度、特异度、阳性预测值、阴性预测值。结果本组120例孕妇中，78例（65.0%）CL ﹤30 mm，其中59例（75.6%）发生早产；42例 CL≥30 mm，其中13例（30.9%）发生早产。CL ﹤30 mm 孕妇早产发生率高于 CL≥30 mm 孕妇（χ2＝20.893，P ＝0.000）。120例早产孕妇 CL 值为明显低于足月产孕妇（ t ＝5.752，P ＝0.000）。120例孕妇中 fFN（＋）89例（74.2%），其中65例（78.0%）发生早产；fFN（-）31例，其中7例（22.6%）发生早产，fFN（＋）孕妇早产发生率高于 fFN（-）孕妇（χ2＝22.329，P ＝0.000）。所有孕妇中，CL ﹤30 mm且 fFN（＋）共57例，均发生早产。CL、fFN 联合检测与二者分别单独检测敏感度差异无统计学意义（与 fFN 检测比较χ2＝3.434，P ＝0.064），但 CL、fFN 联合检测特异度和阳性预测值均为100%，分别高于 CL 检测的60.4%和 fFN 检测的78.0%（χ2＝23.688、18.395，P ＝0.000、0.000）。结论超声 CL 测量联合宫颈分泌物 fFN 检测可提高早产预测的准确率，有利于改善先兆早产孕妇妊娠结局。
목적：탐토초성궁경장도（CL）검측연합궁경분비물태인섬유련접단백（fFN）검측재조산예측중적림상개치。방법대2011년1월지2013년1월기간수치적120례선조조산잉부분별진행초성 CL 검측화궁경분비물 fFN검측，비교량충방식분별단독검측화연합검측예측조산민감도、특이도、양성예측치、음성예측치。결과본조120례잉부중，78례（65.0%）CL ﹤30 mm，기중59례（75.6%）발생조산；42례 CL≥30 mm，기중13례（30.9%）발생조산。CL ﹤30 mm 잉부조산발생솔고우 CL≥30 mm 잉부（χ2＝20.893，P ＝0.000）。120례조산잉부 CL 치위명현저우족월산잉부（ t ＝5.752，P ＝0.000）。120례잉부중 fFN（＋）89례（74.2%），기중65례（78.0%）발생조산；fFN（-）31례，기중7례（22.6%）발생조산，fFN（＋）잉부조산발생솔고우 fFN（-）잉부（χ2＝22.329，P ＝0.000）。소유잉부중，CL ﹤30 mm차 fFN（＋）공57례，균발생조산。CL、fFN 연합검측여이자분별단독검측민감도차이무통계학의의（여 fFN 검측비교χ2＝3.434，P ＝0.064），단 CL、fFN 연합검측특이도화양성예측치균위100%，분별고우 CL 검측적60.4%화 fFN 검측적78.0%（χ2＝23.688、18.395，P ＝0.000、0.000）。결론초성 CL 측량연합궁경분비물 fFN 검측가제고조산예측적준학솔，유리우개선선조조산잉부임신결국。
Objective To investigate the clinical value of the sonographic measurement of cervical length(CL)combined with cervical secretions fetal fibronectin(fFN)detection in prediction of preterm delivery. Methods CL and fFN of cervical secretion were determined in 120 cases of threatened premature labor admitted from January 2011 to January 2013. The sensitivity,specificity,positive predictive value and negative predictive value of CL measurement and fFN detection alone and in combination in predicting preterm delivery were evaluated and compared. Re-sults CL ﹤ 30 mm was found in 78 cases(78 / 120,65% ),of which 59(75. 6% )were preterm delivery;CL ≥ 30 mm was found in 42 cases (42 / 120,30. 9% );of which 13 were preterm delivery. Preterm birth incidence of the pregnant women with CL ﹤ 30 mm was higher than those pregnant women with CL ≥ 30 mm(χ2 = 20. 893,P = 0. 000). CL value of women in preterm labor was significantly lower than that of full -term pregnant women( t = 5. 752,P = 0. 000). fFN positive was found in 89 cases(89 / 120,74. 2% ),of which 65(78. 0% )were preterm delivery;fFN negative was found in 31 cases,of which 7(22. 6% )were in premature birth,preterm birth incidence of pregnant women with fFN positive was higher than that of pregnant women with fFN negative(χ2 = 22. 329,P = 0. 000). Among all pregnant women,CL ﹤ 30mm and fFN positive were found in 57 cases,and all were preterm delivery. Compared the sensitivity of the combination of fFN detection and CL measurement with that of the individual examination alone,the difference was not statistically significant(χ2 = 3. 434,P = 0. 064),but the specificity and pos-itive predictive value of the combined examination of fFN and CL were 100% ,they were respectively higher than the detection of fFN(60. 4% ) and CL(78. 0% )(χ2 = 23. 688,18. 395,P = 0. 000). Conclusion Ultrasound measurement of CL combined with fFN detection in cervical secretions can improve the accuracy of prediction of preterm labor,and it can improve the pregnancy outcome of threatened premature labor.