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目的 探讨阴道超声、细胞因子———白细胞介素 (IL) 6、8及人绒毛膜促性腺激素 (hCG)对足月妊娠宫颈成熟度、临产时间的预测价值。方法 检测 79例足月初产妇宫颈阴道分泌液IL 6、IL 8及hCG水平 ;通过阴道超声测量孕妇宫颈长度、宫颈内口楔形区宽度、前羊膜囊长度 ;同时进行宫颈Bishop评分。结果 (1)IL 6、IL 8、hCG临产后水平 [分别为 (782± 5 0 8)ng/L、(10 5 3 9± 8680 )ng/L、(114± 86)IU/L]较临产前 [分别为 (15 5± 75 )ng/L、(7113± 60 5 0 )ng/L、(3 5± 2 1)IU/L]显著升高 ,差异有极显著性 (P <0 0 5 )。 (2 )IL 6、IL 8、hCG、宫颈长度、前羊膜囊长度均与宫颈Bishop评分显著相关(r=0 42、0 2 4、0 44、- 0 5 6、0 3 5 ,P <0 0 5 )。 (3 )IL 6、IL 8、宫颈长度、前羊膜囊长度、宫颈Bishop评分均与临产时间显著相关 (r=- 0 42、- 0 46、0 64、- 0 5 2、- 0 41,P <0 0 1) ;且均能预测 1周内临产 ,其中宫颈长度的预测效果最好。宫颈长度≤ 3 0mm者 ,预测其在 1周内分娩的灵敏度、特异度、阳性预测值、阴性预测值分别为 0 83、0 89、0 91、0 81。 (4)多因素分析显示 :阴道超声测量宫颈长度 ,预测宫颈成熟度和临产时间的价值优于其他指标。结论 孕妇宫颈阴道分泌液IL 6、
Objective To investigate the predictive value of vaginal ultrasound, cytokines IL-6,8 and human chorionic gonadotropin (hCG) on the maturity and duration of term pregnancy in term pregnancy. Methods Serum levels of IL 6, IL 8 and hCG were measured in 79 cases of full term primiparous cervix. The cervical length, the width of the wedge of the cervix and the length of the anterior amniotic membrane were measured by vaginal ultrasound. The cervical Bishop score was also evaluated. Results (1) The levels of IL 6, IL 8 and hCG after labor were (782 ± 588) ng / L, (1053 ± 8680) ng / L and (114 ± 86) IU / L, respectively Prepartum [(15 5 ± 75) ng / L, (7113 ± 60 5 0) ng / L, (3 5 ± 2 1) IU / L] were significantly increased, with significant differences 0 5). (2) The IL-6, IL-8, hCG, cervical length and anterior amniotic sac length were significantly correlated with cervical Bishop score (r = 0 42,024,044,056,035, P <0 0 5). (3) IL 6, IL 8, cervical length, anterior amniotic sac length and cervical Bishop score were significantly correlated with labor duration (r = - 0 42, - 0 46, 64, - 0 52, - 0 41, P <0 0 1). All of them were predictive of labor within 1 week, of which cervical length was the best. Cervical length ≤ 30mm who predict the sensitivity, specificity, positive predictive value, negative predictive value of 0 83,0 89,0 91,081 childbirth within 1 week. (4) Multivariate analysis showed that the value of vaginal ultrasound in measuring the length of the cervix, predicting the degree of cervical maturity and the duration of labor was superior to other indexes. Conclusion Cervix vaginal secretions IL 6,