经会阴超声测量宫颈长度、胎儿纤维连接蛋白联合血清一氧化氮在预测早产中的临床价值

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摘要目的探讨经会阴超声测量宫颈长度、胎儿纤维连接蛋白联合血清一氧化氮（NO）在预测早产中的价值。方法选择2016年1月～2017年12月广东省汕头市澄海区人民医院收治的先兆早产孕妇50 例（观察组）及同期健康孕妇50 例（对照组）进行研究，分别对其宫颈长度、胎儿纤维连接蛋白联合血清NO 进行检测，并对其预测价值进行分析。结果观察组的宫颈长度明显短于对照组，胎儿纤维连接蛋白及血清NO 水平明显高于对照组（P＜0.05）。相关性分析结果提示，宫颈长度与胎儿纤维连接蛋白成显著负相关（r=-0.542，P=0.011），宫颈长度与血清NO 成显著负相关（r=-0.403，P=0.028），胎儿纤维连接蛋白与血清NO 成显著正相关（r=0.349，P=0.028）。宫颈长度单独检测最佳阈值为29.75 mm，曲线下面积（AUC）=0.859，P=0.010，95%置信区间为（0.787，0.931），敏感度为75.27%，特异度为73.83%；胎儿纤维连接蛋白单独检测最佳阈值为78.21 ng/ml，AUC=0.762，P=0.013，95%置信区间为（0.661，0.863），敏感度为69.08%，特异度为71.17%；血清NO 单独检测最佳阈值为25.75 μmol/L，AUC=0.882，P=0.006，95%置信区间为（0.814，0.949），敏感度为73.81%，特异度为77.08%；联合检测AUC=0.930，P=0.013，95%置信区间为（0.876，0.984），敏感度为83.27%，特异度为81.35%。结论早产孕妇宫颈长度明显短于健康产妇，胎儿纤维连接蛋白及血清NO 水平明显高于健康产妇，经会阴超声测量宫颈长度、胎儿纤维连接蛋白联合血清NO 检测较单独检测对早产预测价值更大。

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关键词 ：经会阴超声, 宫颈长度, 胎儿纤维连接蛋白, 血清NO

Abstract：Objective To investigate the value of transperineal ultrasound measurement of cervical length, fetal fibronectin and serum NO in predicting preterm delivery. Methods From January 2016 to December 2017, 50 pregnant women with threatened preterm birth (observation group) and 50 healthy pregnant women (control group) were enrolled in the People′s Hospital of Chenghai District in Shantou City of Guangdong Province, respectively. Fetal fibronectin combined with serum NO was detected and its predictive value was analyzed. Results The length of the cervix in the observation group was significantly shorter than that in the control group. The levels of fetal fibronectin and serum NO were significantly higher than those in the control group (P＜0.05). Correlation analysis showed that there was a significant negative correlation between cervical length and fetal fibronectin (r=-0.542, P=0.011), and cervical length was significantly negatively correlated with serum NO (r=-0.403, P=0.028), fetal fiber. Connexin was significantly positively correlated with serum NO (r=0.349, P=0.028). The optimal threshold for cervical length alone detection was 29.75 mm,area under the curve (AUC)=0.859, P=0.010, 95% confidence interval was (0.787, 0.931), sensitivity was 75.27%,specificity was 73.83%； optimal threshold for fetal fibronectin alone detection 78.21ng/ml, AUC=0.762, P=0.013, 95%confidence interval was (0.661, 0.863), sensitivity was 69.08%, specificity was 71.17%； optimal threshold for serum NO detection alone was 25.75 μmol/L, AUC=0.882, P=0.006, 95% confidence interval was (0.814,0.949), sensitivity was 73.81%, specificity was 77.08%. The AUC joint detection was 0.930, P=0.013, 95% confidence interval was (0.876, 0.984), sensitivity was 83.27 %, specificity was 81.35%. Conclusion The length of cervix in premature pregnant women is significantly shorter than that in healthy women. The levels of fetal fibronectin and serum NO are significantly higher than those of healthy women. The measurement of cervical length, fetal fibronectin and serum NO by perineal ultrasound is more predictive of preterm birth than the separate test. .

Key words： Transesophageal ultrasound Cervical length Fetal fibronectin Serum NO

基金资助:广东省汕头市科技计划医疗卫生类别项目（1708 23171931323）

作者简介: 林巧玉（1981-），女，本科，主治医师，研究方向：超声诊断

引用本文:

林巧玉；罗梅花. 经会阴超声测量宫颈长度、胎儿纤维连接蛋白联合血清一氧化氮在预测早产中的临床价值[J]. 中国当代医药, 2019, 26(9): 112-116.
LIN Qiao-yu； LUO Mei-hua. Clinical value of transperineal ultrasound measurement of cervical length,fetal fibronectin and serum nitric oxide in predicting preterm delivery. 中国当代医药, 2019, 26(9): 112-116.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2019/V26/I9/112

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