论文部分内容阅读
目的:通过检测孕中期孕妇血浆纤连蛋白FFN(Fetal fibronectin)值,预测妊娠期高血压疾病HDCP(Hyper-tensive disorder complicating pregnancy)及围产儿预后,为临床上确立FFN预测值及早期防治该病的发生提供理论依据。方法:以在产科门诊进行常规检查的孕24~28周孕妇作为研究对象。选择符合纳入和排除标准的孕妇,抽取孕妇肘静脉血5ml,加抗菌素凝剂,采用酶联免疫吸附法测血浆中FFN含量,分别选取第90、95、97.5百分位值作为候选值,通过计算约登指数确定预测值,评价预测效果,严格追踪选定病例的妊娠结局,记录围产儿出生体重、阿氏评分、记录新生儿出生孕周。结果:所有参加检测的孕妇均完成所有相关检测项目,并追踪到妊娠结局。以FFN≥189.5mg/L作为预测值差异有统计学意义(P<0.01),其约登指数为0.42,灵敏度为48%,特异度为94%,阳性预测值为40%,阴性预测值为95%。以FFN≥189.5mg/L作为预测值,将选定病例分为阴性组与阳性组。阳性组的胎儿体重、孕周和1、5、10分钟Apgar评分明显低于阴性组,差异有统计学意义(P值均<0.05)。结论:FFN预测妊娠期高血压疾病具有很高的特异性和阴性预测价值,可以做为妊娠期高血压疾病的筛查指标及围生儿预后的参考指标。
OBJECTIVE: To predict the serum levels of FFN (Fetal fibronectin) in pregnant women in the second trimester to predict the prognosis of hypertensive disorder complicating pregnancy (HDCP) and the prognosis of perinatal pregnancy. To establish the FFN predictive value and prevent and cure the disease early Provide a theoretical basis for the occurrence of. METHODS: Pregnant women aged 24 to 28 weeks who underwent routine examination at the obstetrics clinic were enrolled. Select pregnant women eligible for inclusion and exclusion criteria, the extraction of 5ml pregnant elbow venous blood, plus antibiotic coagulant, the use of enzyme-linked immunosorbent assay FFN content in the plasma, respectively, the 90th, 95th and 97.5th percentile values were selected as the candidate values, The Youtai index was calculated to determine the predicted value, and the prediction effect was evaluated. The pregnancy outcome of the selected cases was strictly followed. The birth weight and Ah’s score of perinatal children were recorded, and the gestational weeks of newborns were recorded. Results: All the pregnant women who participated in the testing completed all the related testing items and tracked the pregnancy outcome. With FFN≥189.5mg / L as the predictive value, the difference was statistically significant (P <0.01). The Yoden index was 0.42, the sensitivity was 48%, the specificity was 94%, the positive predictive value was 40%, the negative predictive value was 95%. With FFN≥189.5mg / L as the predictive value, the selected cases were divided into negative group and positive group. The positive rates of fetal weight, gestational age, and Apgar scores at 1, 5 and 10 minutes were significantly lower in the positive group than in the negative group (P <0.05). CONCLUSION: The predictive value of FFN for hypertensive disorders of pregnancy has high specificity and negative predictive value, which can be used as a screening index of gestational hypertension and a reference index of perinatal prognosis.