摘要
目的:探讨25-OH-D联合宫颈结构变化在预测早产风险的临床价值。方法:将2018年8月~2020年8月诊断为先兆早产的90例孕妇纳入研究,同时设定60例无先兆早产孕妇作为正常对照组,所有入组者均接受彩超检查宫颈结构变化,用酶联免疫吸附法(ELISA)测定外周血25-OH-D水平的变化,分析宫颈结构变化与25-OH-D水平和早产之间的关系。结果:根据分娩结局将90例先兆流产孕妇分为足月组和早产组各45例,早产组宫颈长度短于足月组及正常组,差异有统计学意义(P<0.05),早产组宫颈漏斗发生率、宫颈指数均高于足月组及正常组,差异有统计学意义(P<0.05);早产组血清25-OH-D浓度低于足月组及正常组,差异有统计学意义(P<0.05);ROC曲线提示:宫颈长度和25-OH-D浓度的cut off阈值分别是29.4mm及17.9μg/ml,曲线下面积分别是0.85、0.82;将宫颈长度29.44mm及25-OH-D水平17.9μg/ml设为临界点,联合两个指标检测后对早产的预测灵敏度和特异度分别为95.11%、93.29%,阳性预测值和阴性预测均超过90%。结论:25-OH-D联合宫颈结构变化可敏感、有效地预测早产,临床建议推广应用。
Objective:To investigate the clinical value of 25-OH-D combined with cervical structural changes in predicting the risk of premature delivery.Methods:90 pregnant women diagnosed as threatened preterm delivery from August 2018 to August 2020 were included in the study,and 60 pregnant women without preterm delivery were selected as normal group.All participants underwent color ultrasound examination for cervical structural changes,the changes of 25-OH-D in peripheral blood were measured by enzyme-linked immunosorbent assay(ELISA),and the relationship between cervical structural changes,25-OH-D level and preterm delivery was analyzed.Results:According to the delivery outcome,90 pregnant women with threatened abortion were divided into full term group(n=45)and premature group(n=45).The cervical length in the premature group was shorter than that in the full term group and the normal group,and the difference was statistically significant(P<0.05).The incidence of cervical funnel and cervical indexes in the premature group were significantly higher than those in the full term group and the normal group(P<0.05).The concentration of serum 25-OH-D in premature group was significantly lower than that in full term group and normal group(P<0.05).The ROC curve suggested that the cut off thresholds of cervical length and 25-OH-D concentration were 29.4mm and 17.9μg/ml,and the areas under the curve were 0.85,0.82 respectively.The cervical length 29.44mm and 25-OH-D level 17.9μg/ml were set as the critical point,and the predictive sensitivity and specificity for premature delivery were 95.11%and 93.29%,respectively.Both positive predictive value and negative predictive value were more than 90%.Conclusion:25-OH-D combined with cervical structural changes can sensitively and effectively predict premature delivery,which is recommended to be popularized and applied in clinical practice.
作者
吴芳
李宜静
朱小灵
Wu Fang;Li Yijing;Zhu Xiaoling(Department of Gynaecology and Obstetrics,Yusheng Maternity Hospital,Henan Province,Zhoukou 466700)
出处
《数理医药学杂志》
CAS
2022年第2期163-166,共4页
Journal of Mathematical Medicine
关键词
早产
预测
宫颈结构
25-OH-D
premature delivery
prediction
cervical structure
25-OH-D
