Ai Fang, Li Gui-Qing, Jiang Jiang, Dong Xu-Dong
Department of Obstetrics, The First People's Hospital of Yunnan, Kunming, Yunnan 650032, P.R. China.
Exp Ther Med. 2015 Aug;10(2):665-670. doi: 10.3892/etm.2015.2508. Epub 2015 May 21.
The aim of this study was to investigate the predictive values (PVs) of neutrophil elastase (NE) and fetal fibronectin (fFN) in cervical secretions for single-birth premature delivery. Samples of cervical secretions were obtained from 144 women with high-risk singleton pregnancies at 20-34 weeks' gestation and premature Creasy scores of >12 points for NE and fFN level testing, and the PVs of the two indicators for premature birth (PB) were retrospectively analyzed. NE and fFN had high negative PVs (NPVs) for PB; the NPV of NE and fFN for delivery 7 days after detection was significantly higher than the positive PV (P<0.01). In addition, the sensitivity of the combined use of NE and fFN levels for PB prediction was high if both were present, and the PB rate of the double-positive group was higher than that of the single-positive group (P<0.01). Clinical intervention could turn the NE and fFN values negative in certain cases; in these cases, the PB rate was significantly lower than that in the sustained-positive group. In conclusion, NE and fFN in cervical secretions could be used as objective predictors of premature delivery, and their combined application could improve the prediction sensitivity. Effective clinical intervention could then reduce the incidence of PB.
本研究旨在探讨宫颈分泌物中中性粒细胞弹性蛋白酶（NE）和胎儿纤连蛋白（fFN）对单胎早产的预测价值（PVs）。在妊娠20 - 34周时，从144名单胎高危妊娠妇女中获取宫颈分泌物样本，进行NE和fFN水平检测，早产Creasy评分>12分，回顾性分析这两项指标对早产（PB）的PVs。NE和fFN对PB具有较高的阴性预测值（NPVs）；检测后7天分娩的NE和fFN的NPV显著高于阳性预测值（P<0.01）。此外，如果NE和fFN均呈阳性，则联合使用二者水平预测PB的敏感性较高，双阳性组的PB发生率高于单阳性组（P<0.01）。在某些情况下，临床干预可使NE和fFN值转为阴性；在这些情况下，PB发生率显著低于持续阳性组。总之，宫颈分泌物中的NE和fFN可作为早产的客观预测指标，联合应用可提高预测敏感性。有效的临床干预可降低PB的发生率。
