阴道液β-hCG测定联合pH试纸在诊断胎膜早破的临床应用价值

摘要

目的:比较阴道液β-HCG定性检测(早孕试条)联合pH试纸与单一pH试纸检测在胎膜早破中的诊断价值,探索一种简便、准确、临床应用广的诊断可疑胎膜早破的方法.方法:选取胎膜早破孕妇和正常妊娠孕妇各137例,分别行阴道液β -hCG定性检测和pH试纸检测,放射免疫法定量检测阴道液血清β -hCG浓度.结果:阴道液定性诊断胎膜早破的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为:97.08％、94.16％、95.62％、94.33％和96.99％,与pH试纸比较有显著差异(P＜0.05).早孕试条和pH试纸联合检测的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为:86.13％、97.81％、91.97％、97.52％、87.58％；与单一pH试纸检测比较,特异度显著提高(P＜0.05).阴道液β-hCG定量检测诊断胎膜早破的价值与定性检测无统计学差异(P＞0.05).结论:阴道液β-hCG的定性和定量检测是诊断胎膜早破的可靠方法,其准确率、灵敏度和特异度都高于pH试纸,与pH试纸联合应用,特异度大大增加,更适用于难辨性胎膜早破的诊断.%Objective: To study the value of vaginal washing fluid β-hCG for the diagnosis of premature rupture of membranes(PROM) and to find a simple and accur marker for the diagnosis of PROM. Method: Vaginal washings β-hCG and pH were measured by qualitative analysis in 137 cases with PROM and in 137 cases of normal pregnant women. The levels of vaginal washings β-hCG were estimated by raioimammun oas-say and immunoprecipition neheloetric assay. Result: The sensitivity, specificity, accuracy, positive predi-etivity and negative predictivity were 97.08% ,94.16% ,95. 62% ,94.33% and 96.99% in detecting vaginal washings (β-hCG by qualitative analysis. It was statistically significantly difference with nitazine test(P< 0. 05 ). Vaginal fluid β-hCG value of quantitative analysis and qualitative diagnosis of PROM was not statistically no difference detected (P <0. 05). The sensitivity, specificity, accuracy, positive predietivity and negative predictivity were 86.13% , 97.81% ,91.97% , 97.52% and 87.58% , when the qualitative measurement was combined with nitazine test. Comparison with nitazine test, the specificity was significantly higher ( P <0.05). Vaginal fluid p-hCG value of quantitative analysis and qualitative diagnosis of PROM was no statistically difference detected (P >0.05). Conclusion: Vaginal fluid p-hCG testing is qualitative and quantitative reliable method for diagnosis of PROM, the accuracy rate. The sensitivity and specificity are higher than the pH test paper, combined with the pH test paper, and the specificity increase significantly, It 's more suitable for the diagnosis of suspected PROM.