IL-6水平及宫颈长度测量在早产预测中的作用  

Preterm birth prediction with interleulin-6 and cervical length in pregnant women with preterm labor

作　　者：李佳咛[1] 项方芳[2] 黄丽萍[3] 吴钦兰[1] 赵期菊[1] 邹一梅[1] 

机构地区：[1]广州医学院附属深圳沙井医院妇科,广东深圳518104 [2]广州医学院附属深圳沙井医院体检中心,广东深圳518104 [3]广州医学院附属深圳沙井医院产科,广东深圳518104

出　　处：《同济大学学报（医学版）》2012年第4期104-107,共4页Journal of Tongji University(Medical Science)

基　　金：深圳市宝安区科技项目(2009404)

摘　　要：目的白细胞介素-6(interleulin-6,IL-6)和宫颈长度测量单独及二者联合检测对先兆早产孕妇最终发生早产的预测价值。方法 60例诊断为先兆早产需要住院保胎治疗的单胎妊娠孕妇作为研究对象,测定孕妇外周血IL-6值及超声测量子宫颈长度,追踪其妊娠结局。孕37周前分娩者为早产,孕37周后分娩者为足月产。计算单独及联合使用两种方法预测早产的敏感度、特异度、阳性预测值和阴性预测值等指标。结果 60例先兆早产孕妇中,8例IL-6呈阳性,其中,4例孕妇早产,早产率为50.00%(4/8);52例呈阴性的孕妇仅1例早产。55例先兆早产孕妇超声测量宫颈长度,宫颈长度≤2.6 cm的孕妇有5例,其中4例早产,早产率为80.00%(4/5);50例宫颈长度>2.6 cm的孕妇中有1例发生早产。IL-6预测早产的敏感度、特异度、阳性预测值和阴性预测值分别为80.00%(4/5),92.73%(51/52),80.00%(4/5),92.73%(51/52);而宫颈长度预测早产的敏感度、特异度、阳性预测值和阴性预测值分别为80.00%(4/5),98.00%(49/50),80.00%(4/5),98.00%(49/50);二者联合预测,则上述指标分别为80.00%(4/5),100.00%(45/45),100.00%(4/4),97.83%(45/46)。结论 IL-6与宫颈长度超声测量均是有价值的早产预测手段,二者联合使用,可以提高预测早产孕妇的特异度和阳性预测值。Objective To investigate the predictive value of interleulin-6 （IL-6） and cervical length alone and combination for detection preterm birth in pregnant women with preterm labor. Methods Sixty cases of singleton pregnant women who threatened premature labor needs of hospitalized tocolysis were studied. Serum IL-6 levels and cervical length under transabdominal ultrasound scan weremeasured. The outcomes were recorded and the sensitivity, specificity, positive predictive value （PPV） and negative predictive value （NPV） of IL-6 and cervical length and their combination were analyzed statistically. Results Among 60 cases, positive IL-6 was detected in 8 cases in which 4 cases of premature delivery. The prevalence of preterm delivery among those women with IL-6 （ ＋ ） was 50.00% （4/8）. Only one preterm birth occurred among those 52 cases with IL-6 （ - ）. In 55 pregnant women with preterm labor under trans-abdominal ultrasound scan, 5 cases cervical length was less than 2.6 cm, and 4 cases of which were delivered within 37 weeks （ 80% ）. One preterm birth occurred among the 50 cases with cervical length longer than 2.6 cm. The sensitivity, specificity, PPV and NPV of IL-6 for preterm birth were 80.00% （4/5）, 92.73% （51/52）, 80.00% （4/5） and 92.73% （51/52） mad for cervical length, they were 80.00% （4/5）, 98.00% （49/50）, 80.00% （4/ 5） and 98.00% （49/50）. Combined with IL-6 and cervical length, the sensitivity, specificity, PPV and NPV were 80. 00% （4/5）, 100. 00% （45/45）, 100. 00% （4/4） and 97. 83% （45/46）, respectively. Conclusion IL-6 is valuable in predicting preterm birth in women with preterm labor. Cervical length is also an important means for predicting the preterm birth. IL-6 combined with cervical length can improve the specificity and positive predictive rate.

关 键 词：白细胞介素-6 超声检查 子宫颈长度 早产预测 

分 类 号：R714.21[医药卫生—妇产科学]