Objective To explore the predictive value of fetal fibronectin ( fFN) combined with cervical length measurement for preterm birth. Methods A total of 124 pregnant women with threatened preterm birth were enrolled in this study . All cases were assigned into two groups: preterm group (n=44) and full-term group (n=80). The cervical length was measured by ultrasonography . The fFN expression was detected by double -antibody sandwich immunosorbent assay . Results The positive rates of fFN in preterm group and full -term group were 72.7% and 22. 5% ,respectively,which was higher in preterm group than that in full -term group(P<0.05). The preterm delivery was predicted by fFN with sensitivity 72.7% ( 32/44 ) , specificity 77.5 % ( 62/80 ) , missed diagnosis rate 27. 3 % (12/44 ) , misdi-agnosis rate 22.5% (18/80) ,positive predictivevalue of 64. 0% (32/50) ,and negative predictive value 83. 8% (62/74). The average cervical length in preterm group and full-term group were(21. 34 ±5.08)mm and (29. 59 ± 5.46) mm, respectively, which was shorter in preterm group than that in full-term group (P <0.05). The preterm delivery was predicted by cervical length measurement with sensitivity 68. 2% (30/44) ,specificity 76.2% (61/80) ,missed diagnosis rate 31. 8% (14/44) ,misdiagnosis rate 23. 8% (19/80) positive predictive value 61. 2% (30/49) ,and negative predictive value 81. 3% (61/75). The preterm delivery was predicted by fFN combined with cervical length measurement with sensitivity 90. 9% (40/44) ,specificity 88. 8% (71/80) ,missed diagnosis rate 9.1% (4/44) ,misdiagnosis rate 11.2% (9/80) ,positive predictive value 81. 6% (40/49) ,and negative predictive value 94. 7% (71/75) , which was better than that predicted by fFN or cervical length (P <0.05). Conclusion The fFN combined with cervical length measurement showed ef -fectively to predict preterm birth , which was worthy of clinical application.%目的 探讨胎儿纤维连结蛋白(fFN)和宫颈长度联合测量预测早产的临床应用价值.方法 收集我院妇产科2010年10月-2012年6月收治的先兆早产的孕妇124例,根据其结局分为早产组(n=44)和足月组(n=80).彩色多普勒超声诊断仪测量宫颈长度,双抗体夹心免疫层析法检测fFN的表达.结论 早产组和足月组中fFN 的阳性率分别为72.7%和22.5%,早产组显著高于足月组(P<0.05).fFN预测早产的敏感性为72.7%(32/44),特异性为77.5%(62/80),漏诊率为27.3%(12/44),误诊率为22.5%(18/80),阳性预测值为64.0%(32/50),阴性预测值为83.8%(62/74).早产组和足月组中宫颈平均长度分别为(21.34±5.08)mm和(29.59±5.46)mm,早产组显著短于足月组(P<0.05).宫颈长度预测早产的敏感性为68.2%(30/44),特异性为76.2%(61/80),漏诊率为31.8%(14/44),误诊率为23.8%(19/80),阳性预测值为61.2%(30/49),阴性预测值为81.3%(61/75).fFN联合宫颈长度预测早产的敏感性为90.9%(40/44),特异性为88.8%(71/80),漏诊率为9.1%(4/44),误诊率为11.2%(9/80),阳性预测值为81.6%(40/49),阴性预测值为94.7%(71/75).联合检测预测早产的敏感性、特异性、漏诊率、误诊率、阳性预测值以及阴性预测值显著优于fFN 或宫颈长度的单独预测(P<0.05).结论 fFN联合宫颈长度测量预测早产效果显著,值得临床推广应用.
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