早期四维彩超颈项透明层增厚的胎儿染色体异常产前诊断的价值  

The value of early four-dimensional color Doppler ultrasound detection of fetal neck transparent layer thickening in prenatal diagnosis of fetal chromosomal abnormalities

作　　者：张静[1] 谢恺俐 ZHANG Jing;XIE Kaili(Department of Obstetrics,Affiliated Zhuzhou Hospital of Xiangya School of Medicine of Central South University,Zhuzhou 412007,Hunan,China)

机构地区：[1]中南大学湘雅医学院附属株洲医院产科,湖南株洲412007

出　　处：《中国性科学》2020年第6期53-56,共4页Chinese Journal of Human Sexuality

基　　金：2017年株洲市卫生人才135工程项目(ZW20170112)。

摘　　要：目的对早孕期使用四维彩超检测的颈项透明层(NT)胎儿行产前染色体异常诊断的临床研究。方法选取2015年1月至2018年12月中南大学湘雅医学院附属株洲医院诊治的1 750例怀孕11周~13周的孕妇资料作为研究对象。对这1 750例孕妇资料进行回顾性分析,用四维彩超检测胎儿NT,对NT≥2.5的胎儿行染色体异常分析即染色体核型分析。结果检出NT≥2.5mm孕妇为97例,NT平均厚度为(5.2±2.0)mm;对97例NT≥2.5mm胎儿染色体核型分析结果,染色体异常20例,发生率高低顺序为21三体(6例)、1qh+(4例)、16qh+三体(3例);不同孕妇年龄、胎儿性别和NT厚度与染色体异常率之间均具有差异统计学意义(P<0.05),而NT≥5.5mm胎儿染色体异常率高于NT厚度2.5mm-3.5mm和3.5mm^4.5mm胎儿,三组胎儿之间呈现正相关性,差异具有统计学意义(χ^2=13.583,P<0.01);对NT厚度与胎儿染色体异常率之间进行Logistic回归分析显示,胎儿NT增厚是染色体发生异常的独立预测因素。结论在孕初期采用四维彩超对胎儿NT厚度进行检测可以作为产前筛查的一个重要指标,NT厚度增加越多则胎儿发生染色体异常的风险率也越高。Objective To investigate the clinical significance of early four-dimensional color Doppler ultrasound detection of fetal neck transparent layer(NT) thickening in prenatal diagnosis of fetal chromosomal abnormalities. Methods From January 2015 to December 2018, 1750 pregnant women with 11 to 13 week gestational age in our hospital were tested for NT by four-dimensional color Doppler ultrasound. The fetus with NT≥2.5 underwent karyotype analysis. Results 97 cases of NT≥2.5 mm were identified, the average NT thickness being(5.2±2.0)mm. Of the 97 cases, there were 20 cases of chromosomal abnormalities, of which the top three were 21 trisomy(6 cases), 1 qh+(4 cases), 16 qh+ trisomy(3 cases). There were significant differences in the age, fetal gender, NT thickening and chromosomal abnormalities between pregnant women(P<0.05). The detection rate of fetal chromosomes in those with NT≥5.5 mm was higher than those with NT thickness 2.5~3.5 mm and 3.5~4.5 mm, with a positive correlation(χ^2=13.583, P<0.01). Logistic regression equation analysis found that NT thickening was an independent predictor of fetal chromosome abnormalities. Conclusions Ultrasound diagnosis of fetal NT thickness in pregnant women can be used as an important screening index for prenatal chromosome detection. The increase in NT thickness indicates an increased risk of fetal chromosomal abnormalities.

关 键 词：颈项透明层 增厚 四维彩超 产前诊断 染色体畸形 

分 类 号：R714[医药卫生—妇产科学]