胎儿纤维连接蛋白预测早产的临床观察  

Clinical Observation with Fetal Fibronectin in Pregnant Women with Preterm Labor

作　　者：顾丽萍[1] 戴建荣[1] 

机构地区：[1]江苏省苏州市立医院本部,215000

出　　处：《医学理论与实践》2013年第23期3095-3097,共3页The Journal of Medical Theory and Practice

基　　金：南京医科大学科技发展基金面上项目(编号:2010NJMU106)

摘　　要：目的:研究胎儿纤维连接蛋白(fetal fibronectin,fFN)的检测在早产预测中的临床价值。方法:用fFN快速测试条对有先兆早产症状的孕妇进行阴道后穹窿分泌物中fFN的检测,追踪妊娠结局。结果:(1)共检测191例先兆早产孕妇,临床随访实际发生早产者57例,故从症状判断早产的阳性率29.84%,存在70.16%的误差。(2)191例先兆早产孕妇中72例fFN阳性,其中37例发生早产,故fFN阳性者早产的概率为51.39%。(3)阳性孕妇中7d内、14d内、37孕周前分娩率分别为:34.72%、41.67%、51.39%,阴性孕妇中则分别为:9.24%、11.76%、16.81%,对于7d内、14d内、37孕周前分娩的阴性预测值分别为:90.76%、88.24%、83.19%。(4)fFN检测阴性者中有11例在检测结果出现后7d内发生了早产。结论:(1)胎儿纤维连接蛋白的检测提高了从症状及体征来判断早产的阳性率,阴性结果提示短期内不发生早产的价值较大。(2)本研究发现fFN 1周内分娩的阴性预测值为90.76%,低于以往研究的报道。可能由于早产并非单一原因引起,如感染、胎窘、妊娠合并症及并发症、子宫畸形等都可诱发早产,因而单一的fFN检测来预测早产便有一定的局限性。在医患关系紧张的当代,对于fFN阴性检测结果不干预治疗是欠妥当的。Objective： To determine the predictive value of fetal fibronectin（fFN） in preterm labor. Methods： fFN level in discharges from the posterior fornix was measured for peoples who presented with preterm labor. Pregnant outcomes was recorded. Results： （1） We collected 191 pregnancy women,only 57 subjects delivered prematurely, the incidence of preterm birth was 29. 84%, the rate of error with symptom was 70. 16%. （2）Among 191 subjects, positive fFN was detected in 72 cases, and 37 subjects with fFN （q-） delivered prematurely, so it＇s incidence of preterm birth was 51.39%. （3）The prevalence of spontaneous preterm delivery among those women with fFN（＋） within 7 days, 14 days,and 〈37 weeks were 34. 72%, 41. 67%, 51. 39%, respectively, which were significantly higher than those women with fFN（-）（9. 24%, 11.76%, 16. 81 %）. The negative predictive values （NPV） were 90. 76%, 88. 24%, 83. 19 %. （4）11 subjects with fFN（--） ddivered prematurely within 7 days. Conclusion： （l）fFN was valuable in predic- ting preterm birth in women with preterm labor, especially significant for NPV. （2） The NPV with 7 days was 90. 76 %, it was lower than former study. Multiple factors induced preterm labor, such as infection, fetal distress in ute- rus, pregnancy complication and uterine malformation, so only one factor to predict preterm labor was limited. Nonin- tervention to peoples who presented with preterm labor with iFN（-） was not proper.

关 键 词：胎儿纤维连接蛋白 早产 

分 类 号：R714.7[医药卫生—妇产科学]