超声检测妊娠12-28周胎儿脐动、静脉内径对地中海贫血产前筛查的价值探讨  

Determination of the diameters of fetal umbilical artery and umbilical vein in 12 -- 28 gestational weeks in screening thalassemia with ultrasound

作　　者：万里凯[1] 陈彦红[2] 田矛[3] 何冰[1] 王琳[4] 许春梅[2] 

机构地区：[1]广西壮族自治区人民医院生殖医学与遗传中心,南宁530021 [2]广西壮族自治区人民医院超声科,南宁530021 [3]广西壮族自治区人民医院产科,南宁530021 [4]广西壮族自治区人民医院产前诊断中心,南宁530021

出　　处：《中华超声影像学杂志》2011年第9期783-786,共4页Chinese Journal of Ultrasonography

基　　金：基金项目：广西自然科学基金资助项目（桂科基0575040）

摘　　要：目的探讨超声测量胎儿脐动脉、脐静脉内径对地中海贫血（地贫）早期产前筛查的价值。方法对确诊为地贫的120例孕12-28周单胎孕妇行超声检查，选择同期正常胎儿328例为正常组，除常规测量胎儿径线外，加测游离段脐动脉、脐静脉内径，比较两组间测值，通过ROC曲线分析其对地贫的诊断价值。结果地贫组孕12～15＋6周脐动脉、脐静脉内径大于正常组，孕16～19＋6周的脐静脉内径大于正常组，差异有统计学意义（P〈0．05）；20-28周两组间测值无明显差异（P〉0．05）。ROC曲线获取的判别地贫的截断值：孕12～15＋6周脐动脉内径为1．80mm，脐静脉内径为2．95mm；孕16～19＋6周的脐静脉内径为3．80mm。按上述数值判别，对地贫诊断的敏感度分别为83．3％、83．3％、47．80％，特异度分别为90．5％、95．2％、85．4％。结论超声测量脐动脉、脐静脉内径对地贫早期产前筛查有较大价值，可作为产前筛查地贫的高危新指标。Objective To study the value of the diameters of fetal umbilical artery and umbilical vein in early prenatal screening program for thalassemia by ultrasound. Methods A total of 120 cases of singleton pregnant with thalassemia at 12- 28 gestational weeks were detected by ultrasound,328 cases of normal singleton pregnant at 12 - 28 gestational weeks were selected as controls. The diameters of fetal umbilical artery and umbilical vein were tested and compared between the two groups. The diagnostic values were evaluated by ROC curve. Results At 12 - 15＋6 gestational weeks,the diameters of umbilical artery and umbilical vein of thalassemia group were larger than those of control group （P 〈0.05）. At 16- 19＋6 gestational weeks, the diameter of umbilical vein of thalassemia group was larger than that of control group,the differences were significant （ P 〈0.05）. The cutoff threshold of the diameter of fetal umbilical artery was 1.80 mm,the diameter of fetal umbilical vein was 2.95 mm at 12 - 15＋6 gestational weeks,the diameter of fetal umbilical vein was 3.80 mm at 16- 19＋6 gestational weeks, which were obtained by ROC analysis. The sensitivity of this cutoff threshold to identify thalassemia were 83.3%, 83.3%, 47.8%, respectively, while the specificity were 90.50% ,95.2 %, 85.4 %, respectively. Conclusions The diameters of fetal umbilical artery and umbilical vein detected by ultrasound have great value on early prenatal screening of thatassemia,these indexes can be used as an important factors in early prenatal screening of thalassemia.

关 键 词：超声检查 地中海贫血 脐动脉 脐静脉 

分 类 号：R714.5[医药卫生—妇产科学]