Razi Journal of Medical Sciences
مجله علوم پزشکی رازی
RJMS
Medical Sciences
http://rjms.iums.ac.ir
39
journal39
2228-7043
2228-7051
en
jalali
1389
8
1
gregorian
2010
11
1
17
77
online
1
fulltext
fa
بررسی – HCGβ مایع واژینال برای تشخیص پارگی کیسه آب
Evaluation of Vaginal Fluid β-HCG for Diagnosis of Premature Rupture of Membranes
زنان و زایمان
Gynecology
پژوهشي
Research
<h2 style="MARGIN: 0cm 0cm 0pt DIRECTION: rtl" dir="rtl"><span lang="FA"><p></p></span></h2><h4 style="MARGIN: 0cm 0cm 0pt" dir="rtl"><span style="FONT-FAMILY: " lang="FA">زمینه و هدف: پارگی زودرس کیسه آب یکی از مشکلات مهم در حاملگی است و تشخیص موارد مشکوک از اهمیت ویژهای برخوردار است. تحقیقات در زمینه شناسایی یک آزمون ساده ، سریع و قابل اعتماد به منظور تأیید پارگی کیسه آب ادامه دارد. هدف از مطالعه حاضر بررسی</span><span dir="ltr"></span><span style="mso-bidi-language: FA" dir="ltr"><span dir="ltr"></span><font face="Times New Roman"> β-HCG</font></span><span dir="rtl"></span><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> مایع واژینال برای تشخیص پارگی کیسه آب </span><span dir="ltr"></span><span style="mso-bidi-language: FA" dir="ltr"><span dir="ltr"></span><font face="Times New Roman">(Premature Rupture Of Membrane-PROM)</font></span><span dir="rtl"></span><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> است.<p></p></span></h4><h4 style="MARGIN: 0cm 0cm 0pt" dir="rtl"><span>روشکار: مطالعه به صورت مقطعی بر روی 123 زن حامله که همگی در تریمستر سوم حاملگی بودند (سن حاملگی بیشتر از 28 هفته) انجام گرفت. بیماران در سه گروه مبتلا به </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">PROM</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> (41 نفر)، مشکوک به </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">PROM</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> (42 نفر) و کیسه آب سالم (40 نفر) در نظر گرفته شدند. 5 سیسی(</span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">cc</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span>) مایع استریل نرمال سالین به فورنیکس خلفی واژن وارد شد و سپس مایع شستشوی واژن آسپیره گردیده و برای تعیین کمی </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">β-HCG</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> به آزمایشگاه ارسال گردید و میزان </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">β-HCG</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> در سه گروه مقایسه شد.</span><span style="FONT-FAMILY: " lang="AR-SA"> یافتههای به دست آمده با استفاده از نرمافزار </span><font face="Times New Roman"><span dir="ltr">SPSS V.11.5</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="AR-SA"><span dir="rtl"></span> مورد تجزیه و تحلیل قرار گرفت. از آزمونهای آماری </span><font face="Times New Roman"><span dir="ltr">One way ANOVA, t-student</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="AR-SA"><span dir="rtl"></span> و</span><span dir="ltr"></span><span dir="ltr"><span dir="ltr"></span><font face="Times New Roman"> Kroskal-Walis</font></span><span dir="rtl"></span><span style="FONT-FAMILY: " lang="AR-SA"><span dir="rtl"></span> استفاده گردید.<p></p></span></h4><h4 style="MARGIN: 0cm 0cm 0pt" dir="rtl"><span>یافتهها: میزان </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">β-HCG</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> در گروه بدون پارگی کیسه آب </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">mIU/ml</span><span dir="rtl"></span></font><span style="FONT-FAMILY: "><span dir="rtl"></span> </span><span dir="ltr"></span><span style="mso-bidi-language: FA" dir="ltr"><span dir="ltr"></span><span style="mso-spacerun: yes"><font face="Times New Roman"> </font></span></span><span dir="rtl"></span><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span><font face="B Yagut"><span style="mso-spacerun: yes"> </span>7/15 ± 71/7، در گروه با پارگی کیسه آب<p></p></font></span></h4><h4 style="MARGIN: 0cm 0cm 0pt" dir="rtl"><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">mIU/ml</span><span dir="rtl"></span></font><span style="FONT-FAMILY: "><span dir="rtl"></span> </span><span dir="ltr"></span><span style="mso-bidi-language: FA" dir="ltr"><span dir="ltr"></span><span style="mso-spacerun: yes"><font face="Times New Roman"> </font></span></span><span dir="rtl"></span><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span><font face="B Yagut"><span style="mso-spacerun: yes"> </span>34</font></span><span dir="ltr"></span><span style="mso-bidi-language: FA" dir="ltr" lang="FA"><span dir="ltr"></span><font face="Times New Roman">�</font></span><span dir="rtl"></span><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span>/366± 06/468 و در گروه مشکوک به </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">PROM mIU/ml</span><span dir="rtl"></span></font><span style="FONT-FAMILY: "><span dir="rtl"></span> </span><span dir="ltr"></span><span style="mso-bidi-language: FA" dir="ltr"><span dir="ltr"></span><span style="mso-spacerun: yes"><font face="Times New Roman"> </font></span></span><span dir="rtl"></span><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span><font face="B Yagut"><span style="mso-spacerun: yes"> </span>37/316 ± 43/176 گزارش گردید که تفاوت معنیداری را بین سه گروه نشان میداد (٠٠٠/٠)</font></span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">p=</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span>). به منظور تعیین یک </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">Cut off value</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> برای </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">β-HCG</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> از منحنی </span><span dir="ltr"></span><span style="mso-bidi-language: FA" dir="ltr"><span dir="ltr"></span><font face="Times New Roman">(Receiver Operating Characteristics ) ROC</font></span><span dir="rtl"></span><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> استفاده شد که </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">Cut off value</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> حدود </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">mIU/ml</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> 5/79 با حساسیت 93% وویژگی 84% به دست آمد.<p></p></span></h4><h4 style="MARGIN: 0cm 0cm 0pt" dir="rtl"><span>نتیجهگیری:<font face="Times New Roman">β-HCG </font></span><span dir="rtl"></span><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span><font face="B Yagut"><span style="mso-spacerun: yes"> </span>مایع به دست آمده از شستشوی واژینال درموارد مشکوک به </font></span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">PROM</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> و </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">PROM</span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span> قطعی زیادتر از موارد کیسه آب سالم است و میتواند به عنوان یک تست قابل اعتماد مناسب و سریع در تشخیص </span><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">PROM </span><span dir="rtl"></span></font><span style="FONT-FAMILY: " lang="FA"><span dir="rtl"></span><font face="B Yagut"><span style="mso-spacerun: yes"> </span>مورد استفاده قرار بگیرد.<p></p></font></span></h4>
<span style="mso-bidi-language: FA"><strong><font size="5"><font face="Monotype Corsiva"><p></p></font></font></strong></span><p></p><p style="MARGIN: 0cm 0cm 0pt" class="MatnLatin"><span><font face="Verdana"><strong>Background: </strong>Premature Rupture Of Membranes (PROM) is one of the most important problems of pregnancy and accurate diagnosis of suspicious cases is under special concern. In this regard, researches are being conducted in order to find a reliable, fast and simple method for accurate diagnosis. The purpose of the present study is to evaluate vaginal fluid β-HCG for diagnosis of PROM.<b></b></font></span><p></p><p style="MARGIN: 0cm 0cm 0pt" class="MatnLatin"><font face="Verdana"><b><span style="mso-bidi-language: FA" lang="EN">Methods: </span></b><span style="mso-bidi-language: FA" lang="EN">An observational cross sectional study was performed on 123 pregnant women who were in the third trimester of gestation (gestational age more than 28 weeks of pregnancy). The patients were considered in 3 groups including:<span style="mso-spacerun: yes"> </span>PROM group (41 cases), suspicious for PROM (42 cases) and intact membranes (40 cases). Five ml sterile normal saline was introduced in<span style="mso-spacerun: yes"> </span>to the posterior fornix of vagina,<span style="mso-spacerun: yes"> </span>then vaginal<span style="mso-spacerun: yes"> </span>fluid was aspirated and sent to the laboratory for β-HCG measurement. Finally, the amount of β-HCG was compared in the 3 groups. For data analysis student t-test, One way Anova and Kruskal Walis tests were used. SPSS V.11.5 was also used.</span></font><p></p><p style="MARGIN: 0cm 0cm 0pt" class="MatnLatin"><font face="Verdana"><b><span style="mso-bidi-language: FA" lang="EN">Results: </span></b><span style="mso-bidi-language: FA" lang="EN">β-HCG concentration was 7.71±15.7 mIU/ml in the intact membrane group, 468.06±366.34 mIU/ml in the PROM group and 176.43± 316.37 mIU/ml in the suspicious group which showed a significant difference between the 3 groups (p=0.000). In order to find an optimal Cut off value for β-HCG, Receiver Operating Characteristics Curve (ROC) was used and a Cut off value of 79.5 mIU/ml with a sensitivity of 95% and specificity of 84% was determined to be optional.</span></font><p></p><p style="MARGIN: 0cm 0cm 0pt" class="MatnLatin"><font face="Verdana"><b><span style="mso-bidi-language: FA" lang="EN">Conclusion: </span></b><span style="mso-bidi-language: FA" lang="EN">β-HCG is higher in PROM and suspicious for PROM patients, and thus may be used as a suitable, fast and reliable test for detecting PROM.</span></font><p></p><p style="MARGIN: 0cm 0cm 0pt" class="MatnLatin"><span style="mso-bidi-language: FA" lang="EN"></span><p></p></p><p><font face="Verdana"> </font></p></p><p></p></p><p></p></p><p></p></p><p></p>
کلید واژهها: 1- پارگی زودرس کیسه آب 2- β-HCG، 3-غشاهای آمنیوتیک 4-مایع واژینال 5-حاملگی
Keywords: 1) Premature rupture of membranes (PROM) 2) Beta- HCG(β-HCG) 3) Amniotic membranes 4) Vaginal fluid 5) Pregnancy
17
23
http://rjms.iums.ac.ir/browse.php?a_code=A-10-1-1007&slc_lang=fa&sid=1
Sh
Baha Sadri
شهره
بهاء صدریI
3900319475328460015710
3900319475328460015710
No
M
Kashanian
مریم
کاشانیان
3900319475328460015711
3900319475328460015711
Yes
Sh
Khalili
شکوفه
خلیلی
3900319475328460015712
3900319475328460015712
No