早孕期胎儿颈项透明层厚度与结构异常相关性研究  

The relationship between fetal nuchal translucency thickening and structural abnormalities in the first trimester

作　　者：曾秀梅[1] 王坤[1] 梁元豪 刘宸宁 郭红梅[1] 林洋洋[1] 

机构地区：[1]广东省东莞市妇幼保健院超声科,广东东莞523000

出　　处：《医学影像学杂志》2015年第12期2209-2212,2216,共5页Journal of Medical Imaging

基　　金：广东省医学科学技术研究基金(项目编号:A2014861)

摘　　要：目的 研究胎儿颈项透明层（NT）厚度与胎儿结构异常的关系,了解其在评估胎儿预后中的价值。方法 对2013年7月~2014年7月期间孕期在我院行早孕期（11~13＋6周）超声筛查的9537例单胎病例进行回顾性分析,存在颈项透明层增厚、结构异常的病例进行密切追踪随访。结果 早孕期超声筛查发现结构异常及早孕期超声筛查阴性而中、晚孕超声筛查发现结构异常的56例,占0.58%（56/9537）,按NT厚度将其依次分为4组,〈3.0mm、3.0~3.49mm、≥3.5mm、颈部水囊瘤。NT厚度分组中结构异常发生率分别为0.35%（33/9452）,11.5%（3/26）,23.5%（8/34）,48%（12/25）,组间差异具有统计学意义（Fisher确切概率法：χ~2=167.116,P〈0.001）,胎儿结构异常发生率随NT增厚而升高（趋势χ~2检验：χ~2=130.096,P〈0.001）。研究检测的结构异常主要包括心脏、胎儿水肿、中枢神经系统、骨骼肌肉系统,而NT增厚部分占41.07%（23/56）,NT增厚与结构异常有关（四格表的关联分析：Phi系数φ=0.329,P〈0.001）。结论 NT是早孕期超声筛查中的重要指标,有助于胎儿结构异常的高危筛查。早孕期进行规范化胎儿结构超声筛查对于早期诊断胎儿结构异常发挥重要作用。Objective To study the relationship between fetal nuchal translucency （NT） thickening and structural abnor- malities in the first trimester, and to assess the value in fetus prognosis. Methods From July 2013 to July 2014, 9537 ca- ses in ultrasound screening （11-13＋ 6 weeks） were analyzed retrospectively. Those with nuehal translucency thickening or structural abnormalities were close followed-up. Results 56 cases of structural abnormalities （0.58%） were found in the first trimester or during the second and third trimester which were normal earlier. According to the thickness of the NT they were divided into 4 groups in turn： 〈 3.0 mm, 3.0-3.49 mm,≥ 3.5 mm and neck hygruma. The structure abnor- mal rate of each group were 0. 35%（33/9452）, 11.5%（3/26）, 23.5%（8/34）, 48%（12/25）. The difference among the groups was statistically significant （Fisher＇s Exact Test： χ2= 167. 116, P〈0. 001）. The incidence of fetal structural ab- normalities increased with NT thickening （Linear-by-Linear Association： χ2 = 130. 096, P 〈0. 001）. Structural abnormali- ties of the heart, fetal edema, central nervous system and musculoskeletal system were detected in the study. And the NT thickening group accounted for 41.07 % （23/56）. Structural abnormalities had close relation with NT thickening （Associa- tion Analysis： φ=0. 329, P 〈0. 001）. Conclusion NT which is beneficial to the high-risk screening of fetal structural ab- normalities is an important indicator in ultrasound screening in the first trimester. And the standardized ultrasound screen- ing will play an important role in early diagnosis of the abnormal fetuses.

关 键 词：胎儿颈项透明层 早孕期 超声筛查 结构异常 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]