Kubota T, Takeuchi H
Department of Obstetrics and Gynecology, Juntendo University, Juntendo Urayasu Hospital, Chiba, Japan.
J Obstet Gynaecol Res. 1998 Dec;24(6):411-7. doi: 10.1111/j.1447-0756.1998.tb00116.x.
To evaluate the diagnostic value of insulin-like growth factor binding protein-1 (IGFBP-1) as an indicator of ruptured fetal membranes.
IGFBP-1 concentrations were measured on 42 paired cervicovaginal samples before and after membrane rupture, using an immunoenzymatic assay. A PROM test [dipstick detecting IGFBP-1 with a cutoff value of 25 micrograms/l (A)], a BTB test (B), a ROM-Check (C), and a fern test (D) were compared in diagnosing ruptures of the membranes in 48 patients.
The optimal cutoff concentration was between 20.1 micrograms/l and 148.4 micrograms/l by receiver operating characteristic curve analysis. The PROM test had the highest sensitivity (94.7%) and highest specificity (93.3%) (sensitivity of A-D, B-D, C-D and specificity of A-B: p < 0.05 by chi 2-test). Unlike the other tests, the PROM test is unaffected by contamination, cervical dilatation, or uterine contraction.
The measurement of IGFBP-1 in vaginal fluids is useful for the diagnosis of ruptured fetal membranes.
评估胰岛素样生长因子结合蛋白-1（IGFBP-1）作为胎膜破裂指标的诊断价值。
采用免疫酶法对42对胎膜破裂前后的宫颈阴道样本进行IGFBP-1浓度测定。对48例患者的胎膜破裂诊断中，比较了胎膜早破试验[试纸检测IGFBP-1，临界值为25微克/升（A）]、溴麝香草酚蓝试验（B）、胎膜破裂检查（C）和羊齿状结晶试验（D）。
通过受试者工作特征曲线分析，最佳临界浓度在20.1微克/升至148.4微克/升之间。胎膜早破试验具有最高的敏感性（94.7%）和最高的特异性（93.3%）（A-D、B-D、C-D的敏感性以及A-B的特异性：经卡方检验，p<0.05）。与其他试验不同，胎膜早破试验不受污染、宫颈扩张或子宫收缩的影响。
检测阴道液中的IGFBP-1对胎膜破裂的诊断有用。
