IGFBP-1、MMP-9、HCG在足月胎膜早破诊断中的临床意义  

Clinical significance of IGFBP-1,MMP-9 and HCG in the diagnosis of premature rupture of membranes

作　　者：丁其培 王琛琛 陈薇 王秀美[1] DING Qipei;WANG Chenchen;CHEN Wei;WANG Xiumei(Department of Obstetrics and Gynecology,the Affiliated Haian people′s Hospital of Nantong University,Nantong,Jiangsu 226600,China)

机构地区：[1]南通大学附属海安人民医院妇产科,江苏南通226600

出　　处：《检验医学与临床》2018年第8期1101-1104,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨宫颈分泌物中胰岛素生长因子结合蛋白-1(IGFBP-1)、基质金属蛋白酶-9(MMP-9)、人绒毛膜促性腺激素(HCG)在足月胎膜早破诊断中的临床意义。方法选取2015年1月至2016年12月该院收治的足月胎膜早破患者80例,另选取健康孕妇80例为对照组,应用酶联免疫吸附测定(ELISA)检测两组宫颈分泌物中IGFBP-1、MMP-9、HCG的水平,并应用受试者工作特征曲线(ROC)分析IGFBP-1、MMP-9、HCG在胎膜早破诊断中的应用价值。结果胎膜早破组患者经胎盘病理检查为临床绒毛膜羊膜炎的发生率高于对照组(P<0.05)。胎膜早破组胎膜IGFBP-1、MMP-9、HCG阳性率均高于对照组(P<0.05),其中绒毛膜羊膜炎患者胎膜IGFBP-1、MMP-9、HCG阳性率均高于非绒毛膜羊膜炎患者(P<0.05)。经ROC曲线分析可知,IGFBP-1、MMP-9、HCG诊断足月胎膜早破的灵敏度、特异度分别为92.6%、88.2%;82.6%、85.2%;72.6%、88.2%。IGFBP-1、MMP-9、HCG诊断足月胎膜早破绒毛膜羊膜炎的灵敏度、特异度分别为88.6%、90.2%;82.2%、84.2%;80.2%、81.2%。结论联合检测宫颈分泌物中IGFBP-1、MMP-9、HCG的水平可作为足月胎膜早破以及足月胎膜早破孕妇是否发生绒毛膜羊膜炎的诊断标准。Objective To investigate the effects of insulin growth factor binding protein-1(IGFBP-1),matrix metalloproteinase-9(MMP-9)and human chorionic gonadotropin(HCG)on cervical premature rupture of membranes.Methods Eighty cases of patients with premature rupture of membranes were selected and 80 cases of normal pregnant women were selected as the control group.The levels of IGFBP-1,MMP-9 and HCG were measured by ELISA.The value of IGFBP-1,MMP-9 and HCG in the diagnosis of premature rupture of membranes was analyzed by subject specific curve(ROC).Results The incidence of amniotic membrane in patients with premature rupture of membranes was higher than that of control group(P<0.05).The positive rates of IGFBP-1,MMP-9 and HCG in fetal membranes were higher than those of control group(P<0.05).The positive rates of IGFBP-1,MMP-9 and HCG of chorioamnion groups were higher than those of non-chorionic amniotic group(P<0.05).The sensitivity and specificity of IGFBP-1,MMP-9 and HCG in diagnosis of premature rupture of membranes were 92.6%,88.2%,82.6%,85.2%,72.6%,88.2%.The sensitivity and specificity of IGFBP-1,MMP-9 and HCG in chorioamnion groups were 88.6%,90.2%,82.2%,84.2%,80.2%and 81.2%.Conclusion The positive expression of IGFBP-1,MMP-9 and HCG in cervical secretions can not only be used as a diagnostic index for terminating premature rupture of membranes,but also as a diagnostic criterion for chorioamnionitis in pregnant women with premature rupture of membranes.Combined detection of IGFBP-1,MMP-9 and HCG levels in pregnant women will contribute to the diagnosis of premature rupture of membranes and chorioamnionitis.

关 键 词：胰岛素生长因子结合蛋白-1 基质金属蛋白酶-9 人绒毛膜促性腺激素 足月胎膜早破 

分 类 号：R714.21[医药卫生—妇产科学]