胰岛素样生长因子结合蛋白-1与宫颈Bishop评分在预测临产时间中的比较  

Comparison of the insulin-like growth factor-binding protein-1 and the cervical Bishop score in predicting the onset of delivery

作　　者：马秀华[1] 宋风丽[1] 马丽丽[1] 贺笑茜[1] 

机构地区：[1]首都医科大学大兴教学医院,北京市102600

出　　处：《实用医学杂志》2012年第10期1724-1726,共3页The Journal of Practical Medicine

摘　　要：目的:探讨足月妊娠妇女宫颈分泌物中磷酸化胰岛素样生长因子结合蛋白-1(IGFBP-1)和宫颈Bishop评分预测临产时间的价值。方法:对200例妊娠37～41周、未临产、胎膜完整的孕妇,采用免疫层析法进行宫颈分泌物IGFBP-1测定,比较IGFBP-1和宫颈评分预测72h内临产的成功性。结果:宫颈Bishop评分≥7分者IGFBP-1阳性率为95.12%,明显高于<7分者49.69%(P<0.001)。随着宫颈成熟度的增加,IGFBP-1阳性率逐渐升高,IGFBP-1阳性率与宫颈成熟度呈正相关。110例72h内临产者中IGFBP-1阳性108例(98.18%),IGFBP-1阴性2例(1.82%),90例>72h临产者中IGFBP-1阳性10例(11.11%),IGFBP-1阴性80例(88.89%),两者差异有显著性(P<0.001)。IGFBP-1预测72h内临产的敏感性、特异性、阳性预测值和阴性预测值分别是98.18%、88.89%、91.53%、97.56%,而宫颈Bishop评分是31.82%、93.33%、85.37%、52.83%。结论:宫颈分泌物IGFBP-1能反映宫颈成熟度,可作为预测临产时间的一个客观指标。检测IGFBP-1预测临产时间明显优于宫颈评分,其阳性可预测在72h内临产。Objectives The aim of this study is to compare the clinical significanc of phosphorylated insulin-like growth factor-binding protein-1（IGFBP-1） in cervical secretions of full term pregnancy women,and that of cervical Bishop score in predicting the onset of delivery.Methods A total of 200 pregnant women of 37-41 weeks,with intact fetal membranes were enrolled in this study.The IGFBP-1 was determined by immunochromatography and its successful rate in predicting the onset of delivery within 72 hours was assessed by comparison with cervical Bishop score.Results When the cervix Bishop score was greater than or equal to 7,the positive percentage of IGFBP-1 was 95.12%;and when it was less than 7,the positive percentage of IGFBP-1 was 49.69%,the difference was significant（P 0.001）.As cervix maturity degree increased,the positive percentage of IGFBP-1 was rising gradually.There was a significant positive correlation between the cervix maturity and the positive rate of IGFBP-1.Among 110 cases of the onset of delivery within 72 hours,there were 108 cases（98.18%） positive for IGFBP-1,while 2 cases（1.82%） were negative for IGFBP-1.Among 90 cases of the onset of delivery more than 72 hours,there were 10 cases（11.11%） positive for IGFBP-1,while 80 cases（88.89%） were negative for IGFBP-1,the difference was significant（P 0.001）.Within 72 hours before the onset of delivery,the sensitivity,specificity,positive predictive value and negative predictive value of IGFBP-1 were 98.18%,88.89%,91.53% and 97.56%,respectively,While,these values of the Bishop score were 31.82%,93.33%,85.37%,52.83%.Conclusions IGFBP-1 reflects cervical maturation,and it can serve as an objective indicator for predicting the onset of delivery.Determining IGFBP-1 is obviously better than using cervical Bishop score in predicting the onset of delivery,and the positive IGFBP-1 could predict the onset of delivery within 72 hours.

关 键 词：胰岛素样生长因子结合蛋白1 宫颈评分 预测 

分 类 号：R714.7[医药卫生—妇产科学]