LaShay N, Gilson G, Joffe G, Qualls C, Curet L
Department of Obstetrics and Gynecology, University of New Mexico Health Science Center, Albuquerque.
J Matern Fetal Med. 2000 Nov-Dec;9(6):336-41. doi: 10.1002/1520-6661(200011/12)9:6<336::AID-MFM1003>3.0.CO;2-F.
We sought to investigate if determination of cervicovaginal interleukin-6 (IL-6) levels would enhance the positive predictive value of fetal fibronectin (fFN) for preterm birth.
A prospective cohort study was undertaken of 135 women between 24 and 34 weeks gestation with symptoms of suspected preterm labor. Cervicovaginal secretions were collected for both IL-6 and fFN and measured by immunoassay and ELISA, respectively. Outcome variables included preterm delivery in less than 48 h, within 7 days, and prior to 37 weeks. Statistical analysis was performed with Fisher's exact test, regression for logarithmic transform levels, and multivariate logistic regression. ROC curves were created for IL-6 levels.
IL-6 and fFN levels were both elevated in cervicovaginal secretions of women with symptoms of preterm labor. IL-6 values >100 pg/ml resulted in a odds ratio for delivery at <37 weeks of 1.57 (95%CI=0.89-2.75, P=.11), whereas fFN values >50 ng/ml resulted in a preterm delivery risk of 4.58 (95%CI=1.54-13.35, P=.003). Combining IL-6 and fFN results did not improve upon the predictive value of fFN alone for preterm birth [odds ratio 4.00 (95%CI=1.31-12.17, P=.015)].
Cervicovaginal IL-6 levels did not provide any additional, independent effect on the prediction of preterm birth beyond that of fFN testing alone.
我们试图研究测定宫颈阴道白细胞介素-6（IL-6）水平是否会提高胎儿纤连蛋白（fFN）对早产的阳性预测值。
对135名妊娠24至34周有疑似早产症状的妇女进行了一项前瞻性队列研究。收集宫颈阴道分泌物检测IL-6和fFN，分别采用免疫测定法和酶联免疫吸附测定法进行检测。结局变量包括在48小时内、7天内以及37周前早产。采用Fisher精确检验、对数转换水平回归和多因素逻辑回归进行统计分析。绘制了IL-6水平的ROC曲线。
有早产症状的妇女宫颈阴道分泌物中IL-6和fFN水平均升高。IL-6值>100 pg/ml时，37周前分娩的比值比为1.57（95%CI=0.89-2.75，P=0.11），而fFN值>50 ng/ml时，早产风险为4.58（95%CI=1.54-13.35，P=0.003）。联合IL-6和fFN的结果并未比单独使用fFN对早产的预测价值有所提高[比值比4.00（95%CI=1.31-12.17，P=0.015）]。
宫颈阴道IL-6水平对早产预测没有提供超出单独fFN检测的任何额外独立作用。
