胰岛素样生长因子结合蛋白-1诊断胎膜早破的临床价值  

Clinical Value of Insulin-Like Growth Factor Binding Protein-1 in Diagnosis of Premature Rupture of Membranes

作　　者：孙素梅[1] 李守忠[1] 

机构地区：[1]淮安市淮阴医院妇产科,江苏淮安223300

出　　处：《实用临床医学（江西）》2016年第2期43-45,共3页Practical Clinical Medicine

摘　　要：目的探讨胰岛素样生长因子结合蛋白-1诊断胎膜早破的临床价值。方法采用阴道分泌物涂片镜检、pH试纸法、胰岛素样生长因子结合蛋白-1检测法检测276例胎膜早破患者(胎膜早破组)和284例行孕期体检的孕妇(正常对照组,未胎膜早破者)阴道分泌物,并将结果进行统计学分析。结果胎膜早破组胰岛素样生长因子结合蛋白-1检测法、pH试纸法、阴道分泌物涂片镜检检测阳性率均明显高于正常对照组(均P<0.01)。胰岛素样生长因子结合蛋白-1检测法的灵敏度、特异性、准确率分别为97.1%(268/276)、98.2%(279/284)、95.3%,假阳性1.8%(5/284),假阴性2.9%(8/276);pH试纸法的灵敏度、特异性、准确率分别为80.8%(223/276)、89.8%(255/284)、70.6%,假阳性10.2%(29/284),假阴性19.2%(53/276);阴道分泌物涂片镜检的灵敏度、特异性、准确率分别为63.0%(174/276)、95.1%(270/284)、58.1%,假阳性4.9%(14/284),假阴性37.0%(102/276)。胰岛素样生长因子结合蛋白-1检测法的灵敏度、特异性、准确率均明显高于pH试纸法、阴道分泌物涂片镜检,假阳性率、假阴性率均明显低于pH试纸法、阴道分泌物涂片镜检(均P<0.05)。结论胰岛素样生长因子结合蛋白-1用于检测胎膜早破较pH试纸法和阴道分泌物涂片镜检更具准确性及灵敏性,特别对于微小破膜较为敏感,是临床诊断胎膜早破价值较高的指标,对临床确诊胎膜早破具有较大的实用价值。Objective To evaluate the clinical value of insulin-like growth factor binding protein-1（IGFBP-1）in the diagnosis of premature rupture of membranes（PROM）.Methods The vaginal secretion smear microscopy,pH test paper method and IGFBP-1detection were performed in 276 PROM patients（PROM group）and 284 pregnant women without PROM（control group）.Results were analyzed statistically.Results The positive rates achieved by IGFBP-1detection,pH test paper method and vaginal secretion smear microscopy in PROM group were significantly higher than those in control group（all P〈0.01）.The IGFBP-1detection had a sensitivity of97.1%（268/276）,a specificity of 98.2%（279/284）and an accuracy of 95.3%,with a false positive rate of 1.8%（5/284）and a false negative rate of 2.9%（8/276）;The pH test paper method had a sensitivity of 80.8%（223/276）,a specificity of 89.8%（255/284）and an accuracy of70.6%,with a false positive rate of 10.2%（29/284）and a false negative rate of 19.2%（53/276）;The vaginal secretion smear microscopy had a sensitivity of 63.0%（174/276）,a specificity of95.1%（270/284）and an accuracy of 58.1%,with a false positive rate of 4.9%（14/284）and a false negative rate of 37.0%（102/276）.Compared with pH test paper method or vaginal secretion smear microscopy,IGFBP-1detection resulted in an increase in sensitivity,specificity and accuracy and a decrease in false positive rate and false negative rate（all P〈0.05）.Conclusion IGFBP-1detection is more accurate and sensitive than pH test paper method and vaginal secretion smear microscopy for diagnosing PROM,especially for diagnosing minor rupture of membranes.Therefore,GFBP-1detection has clinical and practical value in the diagnosis of PROM.

关 键 词：胎膜早破 阴道分泌物 涂片镜检 PH试纸 胰岛素样生长因子结合蛋白-1 

分 类 号：R714.433[医药卫生—妇产科学] R446[医药卫生—临床医学]