胎儿纤维连接蛋白联合宫颈长度检测对双胎妊娠早产的预测价值  

Study on the predictive value of fetal fibronectin combined with measurement of cervical length in detection of premature birth of twin pregnancy

作　　者：郝静[1] 李彦军[1] 

机构地区：[1]首都医科大学燕京医学院附属良乡医院妇产科,北京102401

出　　处：《临床和实验医学杂志》2016年第14期1431-1433,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨胎儿纤维连接蛋白（f FN）、宫颈管长度（CL）分别检测和联合检测对双胎妊娠发生早产的预测价值。方法收集进行正规产检的64例双胎妊娠孕妇的临床资料,于妊娠26~32周检测孕妇阴道后穹窿分泌物f FN,彩色多普勒超声检测CL,并随访妊娠结局。观察f FN、CL分别检测及联合检测预测双胎妊娠早产的敏感度、特异度和阳性预测值。结果 f FN阳性预测双胎妊娠发生早产的敏感度为73.33%,特异度为65.31%,阳性预测值为39.29%;CL≤25 mm预测双胎妊娠发生早产的敏感度为68.42%,特异度为62.22%,阳性预测值为43.33%。二者联合检测预测双胎妊娠发生早产的敏感度为84.62%,特异度为94.74%,阳性预测值为91.67%;f FN阳性、CL≤25 mm与两种方法联合检测敏感度比较无统计学差异（P〉0.05）,特异度和阳性预测值有统计学差异（P〈0.05）。结论对于双胎妊娠孕妇,f FN检测联合超声测量CL较两项分别检测在预测双胎妊娠发生早产的虽然敏感度差异不显著,但在预测早产的特异度及阳性预测方面有显著优势,临床适用于双胎妊娠发生早产的预测。Objective To explore the predictive value of combined detection of fetal fibronectin （fFN） and measurement of length of eervical tube （CL） in detecion of premature birth of twin pregnancy. Methods The clinical data of 64 cases of twin pregnancy in pregnant women with vaginal fornix secretion for detection of fetal fibroneetin （fFN） during 26 to 32 weeks, and color Doppler ultrasound had been applied for deteetion of length of cervical tube in this hospital were collected and their outcomes of pregnancy were predicted. The sensitivity, specificity and positive predictive value of tFN and CL were observed and combined with prediction of preterm delivery in twin pregnancy. Results In the positive predictive value of fFN and CL in twin pregnancy and preterm delivery, its sensitivity was 73.33 %, specificity was 65.31%, and positive predictive value was 39.29%. The significance of length of cervical tube equal to or less than 25mm had been applied for prediction of premature birth of twin pregnancy and its sensitivity for preterm delivery was 68.42% , its specificity was 62.22% and its positive predictive value was 43.33%. The sensitivity of combination detection was 84.62% , its specificity was 94.74% , and its positive predictive value was 91.67% , and the difference in sensitivitty of detection with combination dictive value was statistically significant （ P 〈 0 tion combined with uhrasound measurement of 1 though the difthrenee in sensitivity is not signifie eal difthrenee and clinical significance in applie of positive fFN and CL ≤25 was not significant, and the difference in specificity and positive pre05 ）. Conclusion For twin pregnancy, the specificity and positive predictive value of fFN detec- ength of cervical tube have been applied for prediction of premature birth of twin pregnancy, alant, but their specificity and positive predictive value in prediction of preterm delivery have statistiation for prediction of preterm delivery, of twin pregnancy.

关 键 词：双胎妊娠 早产 胎儿纤维连接蛋白 宫颈管长度 

分 类 号：R714.21[医药卫生—妇产科学]