目的：探讨检测磷酸化胰岛素样生长因子结合蛋白－1（ phIGFBP－1）联合宫颈指数对早产分娩时间的预测价值。方法先兆早产孕妇160例，进行单一检测宫颈phIGFBP－1、阴道B超测量计算宫颈指数预测早产及两者联合预测早产，比较分娩结局及距离分娩的时间。结果两指标联合预测早产明显优于单一指标预测，且两指标阳性组距离分娩时间明显短于单一指标阳性组及两指标阴性组（P＜0．05）。两指标联合应用对1周内分娩预测的敏感度、特异度、阳性预测值和阴性预测值分别为100％（31／31）、27．9％（36／129）、63．2％（24／38）、100％（36／36）。两指标阳性组中宫颈指数大于0．8者，1周内分娩率为100％，两指标阴性组中1周内分娩的阴性预测值为100％。结论 phIGFBP－1检测联合宫颈指数测定可作为预测早产的客观指标，方法简便易行。%Objective To evaluate the application of phosphorylated insulin like growth factor binding protein-1 ( phIGFBP-1) combined with cervical index in the prediction of premature delivery.Methods A total of 160 pregnant women with threatened preterm labor were enrolled in the study.Their possibilities of preterm labor were evaluated based on the level of phIGFBP-1, measurement of cervical index by transvaginal ultrasound or both.Then, their delivery was recorded.Results The level of phIGFBP-1 combined with cervical index was superior to each method alone in the pre-diction of premature delivery.Patients with two positive results produced remarkably shorter delivery time than those with one positive or two negative results (P<0.05).The combined use of phIGFBP-1 and cervical index showed a sensitivi-ty of 100%(31/31), a specificity of 27.9%(36/129), a positive predictive value of 63.2%(24/38), and a negative predictive value of 100%(36/36).Patients with two positive results and more than 0.8 of cervical index showed a deliv-ery rate of 100%within one week.Patients with two negative results showed a delivery rate of 100% within one week. Conclusion The level of phIGFBP-1 combined with cervical index can be used as an objective index for prediction of premature birth.This combined method is simple and feasible.
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