β-HCG、fFN、AFP定量联合检测诊断胎膜早破的临床价值  

Clinical value of combined guantitative detection ofβ-HCG,fFN and AFP for diagnosing premature rupture of fetal membranes

作　　者：周轶[1] 徐秋莲[1] ZHOU Yi;XU Qiulian(Jinhua People's Hospital,Zhejiang Province,321000)

机构地区：[1]浙江省金华市人民医院,321000

出　　处：《中国计划生育学杂志》2021年第1期75-78,211,共5页Chinese Journal of Family Planning

摘　　要：目的:观察β绒毛膜促性腺激素(β-HCG)、阴道液胎儿纤维连接蛋白(fFN)、阴道分泌中的甲胎蛋白(AFP)定量检测在胎膜早破诊断中的临床价值。方法:选取2017年1月-2018年6月本院产科建档疑似胎膜早破的分娩孕妇400例作为研究对象,以流行病学史、临床表现与实验室涂片镜检结果确诊,其中胎膜早破的224例(确诊组),疑似胎膜早破组176例为疑似组,同期本院产科建档胎膜正常未破的分娩孕妇180例(对照组)。检测各组β-HCG、fFN、AFP阳性检出,绘制曲线下面积(AUC)分析β-HCG、fFN、AFP定量联合检测的诊断价值。结果:确诊组β-HCG、AFP水平高于另外两组(P<0.05),β-HCG诊断胎膜早破误诊率5.7%(10/176)、漏诊率2.8%(6/214);AFP诊断胎膜早破误诊率8.5%(15/176)、漏诊率2.2%(5/224);fFN诊断胎膜早破误诊率9.7%(17/176)、漏诊率1.8%(4/224);3个指标联合检测的敏感度98.2%、特异度98.3%,AUC0.983;确诊组新生儿窒息、子痫前期、早产及羊水过少等发生率高于另外两组(P<0.05)。结论:β-HCG、fFN、AFP定量联合检测可提高孕妇胎膜早破的诊断敏感度,且方法简便、操作性强。Objective:The investigate clinical value of combined quantitative detection of human chorionic gonadotrophinβ(β-HCG),fetal fibroneict(fFN)in vaginal fluid,and alpha-fetoprotein(AFP)in vaginal secretion for diagnosing premature rupture of fetal membranes(PROM).Methods:400 pregnant women with suspected PROM were enrolled as subjects from January 2017 to June 2018.Based on the epidemiological history,clinical manifestations and laboratory smear microscopy results as the gold standard,these women were divided 224 women with PROM in group A and 176 women with suspected PROM in group B,and 180 normal pregnant women were enrolled in group C during the same period.The expression levels ofβ-HCG and AFP,and the rate of positive fFN of women in the three groups were detected.The area under the curve(AUC)was used to analyze the value of combined quantitative detection ofβ-HCG,fFN,and AFP for diagnosing PROM.Results:The levels ofβ-HCG and AFP of women in group A were significant higher than those of women in the other two groups(P<0.05).The misdiagnosis rate and missed diagnosis rate of the level ofβ-HCG for diagnosing PROM were 5%(10/176)and 2.8%(6/214).The misdiagnosis rate and missed diagnosis rate of the level of AFP for diagnosing PROM were 8.5%(15/176)and 2.3%(5/224).The misdiagnosis rate and missed diagnosis rate of fFN for diagnosing PROM were 9.7%(17/176)and 1.8%(4/224).The sensitivity,the specificity,and AUC of the combined detection ofβ-HCG,fFN and AFP were 98.2%,98.3%,and 0.983 respectively.The incidences of neonatal asphyxia,preeclampsia,premature delivery,and oligohydramnios of women in group A were significant higher than those of women in the other two groups(P<0.05).Conclusion:Combined quantitative detection ofβ-HCG,fFN and AFP can enhance the diagnostic sensitivity of pregnant women with PROM,which is simple and maneuverable.

关 键 词：胎膜早破 Β绒毛膜促性腺激素 阴道液胎儿纤维连接蛋白 血清标志物甲胎蛋白 临床检测价值 

分 类 号：R714.433[医药卫生—妇产科学]