孕早期胎儿颈部透明层厚度和鼻骨长度联合检测筛查唐氏综合征的临床价值  

Measurements of fetal nuchal translucency and nasal bone in first-trimester screening for Down syndrome

作　　者：朱艺玲[1] 唐莉[1] 杨小花[1] 吴淑珠[1] 

机构地区：[1]广东省茂名市妇幼保健院,525000

出　　处：《中国计划生育学杂志》2014年第2期98-101,共4页Chinese Journal of Family Planning

基　　金：茂名市科技计划项目(20102108)

摘　　要：目的:探讨利用孕早期胎儿颈部透明层(NT)厚度和鼻骨(NB)长度联合筛查唐氏综合征(DS)的临床价值。方法:将1 206例妊娠11~13+6周的孕妇随机分为两组,观察组(NT+NB组)测量胎儿NT厚度及NB长度,对照组(NT组)测量胎儿NT厚度。对NT或NB测量结果阳性者行羊水穿刺检查胎儿染色体核型并追踪随访。比较两种方法筛查DS的灵敏度、特异度、假阳性率、假阴性率、阳性预测值、阴性预测值和约登指数。结果:NT+NB组与NT组筛查DS方法的灵敏度分别为100%、90%(P<0.05);特异度分别为97.45%、98.15%;假阳性率分别为2.55%、1.85%;假阴性率分别为0、10%(P<0.05);阳性预测值分别为48.25%、45%;阴性预测值分别为100%、99.83%;约登指数(正确指数)分别为97.45%、88%(P<0.05)。结论:孕早期NT和NB联合筛查DS可提高灵敏度和约豋指数,降低假阴性率,具有较高的临床价值。Objective： To explore the application value of measuring fetal nuchal translucency and nasal bone in first-- trimester screening for Down syndrome （DS）. Methods： A total of 1206 pregnant women with 11--13＋6 weeks of ges- tational ages were randomly assigned into group NT and group NT＋NB. The nuchal translucency was measured in group NT, and both nuchal translucency and nasal bone were measured in group NT＋NB. The amniocentesis was con- ducted on patients with positive results. The sensitivity, specificity, false positive rate, false negative rate, positive predictive value, negative predictive value and Youden index were evaluated in two groups. Results：The sensitivity of the screening method in NT^NB group and NT group was 100~ and 90%, respectively （P^0.05） ; the specificity in NT2- NB group and NT group was 97.45 % and 98.15 %, respectively; the false positive rate in NT ＋ NB group and NT group was 2.55% and 1.85%. respectively; the false negative rate in NT4-NB group and NT group was 0 and 10%, respectively （P〈〈0.05）; the positive predictive value in NT＋NB group and NT group was 48.25% and 45%, respectively; the negative predictive value in NT--NB group and NT group was 100% and 99.83%, respectively; and the Youden index in NT＋NB group and NT group was 97.45% and 88%, respectively （P〈0.05）. Conclusion= Meas urements of Nuchal translucency and nasal bone can significantly improve the sensitivity and correct index as well as re duce the rate of misdiagnosis in DS screening.

关 键 词：胎儿 颈部透明层厚度 鼻骨长度 唐氏综合征 

分 类 号：R714.5[医药卫生—妇产科学]