孕早期静脉导管A波倒置联合NT筛查胎儿染色体非整倍体价值  

The value of A wave inversion of venous catheter combined with fetal nuchal translucency value for screening of fetal chromosomal aneuploidy during the first trimester pregnancy

作　　者：陈秀菊 蔡满满 张丽荣 CHEN Xiuju;CAI Man;ZHANG Lirong(Xishan District Maternal and Child Health Care and Family Planning Service Center, Wuxi City, Jiangsu Province, 214000;Wuxi Maternal and Child Health Care Hospital;Wuxi Hongqiao Hospital)

机构地区：[1]江苏省无锡市锡山区妇幼保健计划生育服务中心,214000 [2]江苏省无锡市妇幼保健院 [3]江苏省无锡虹桥医院

出　　处：《中国计划生育学杂志》2020年第11期1894-1897,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨孕早期静脉导管A波倒置联合胎儿颈项透明层(NT)对胎儿染色体非整倍体筛查价值。方法:选取2016年1月~2019年9月在本院接受产前检查的2086例孕11~13周孕妇,均行胎儿静脉导管血流频谱检测和NT检查,以孕妇分娩或引产结局为“金标准”记录染色体非整倍体异常,分析胎儿静脉导管血流频谱、NT超声检测预测胎儿染色体非整倍体异常效率。结果:分娩及引产证实2086例孕早期胎儿染色体非整倍体异常34例(1.63%),胎儿静脉导管A波倒置检出41例,确诊27例(65.9%);NT增厚检出47例,确诊28例(59.5%);二者均异常检出39例,确诊31例(79.5%)。静脉导管A波倒置和NT增厚单独诊断胎儿染色体非整倍体异常的灵敏度(79.4%、58.8%),特异度(99.3%、98.7%),准确率(99.0%、98.0%),阳性预测值(65.9%、42.6%),阴性预测值(99.7%,99.3%),均低于联合检测(91.2%、99.6%、99.5%、79.5%、99.9%)(P<0.05)。结论:孕早期静脉导管A波倒置联合NT检测筛查孕早期胎儿染色体非整倍体,可显著提高诊断灵敏度、特异度和准确率,为临床准确判断及时处理染色体异常胎儿提供有效依据。Objective:To investigate the value of A wave inversion of venous catheter combined with fetal nuchal translucency(NT)value for screening fetal chromosomal aneuploidy of pregnant women during the first trimester of pregnancy.Methods:From January 2016 to September 2019,2086 pregnant women who received NT ultrasound examination during 11-13 gestational weeks were selected as the study objects,and all these women were given the examination of blood flow spectrum of fetal venous catheter and fetal NT.The diagnosis"gold standard"was based on the delivery outcomes or induction outcomes.The abnormal chromosome aneuploidy of fetus was recorded.The blood flow spectrum of fetal venous catheter and the fetal NT value by ultrasound were analyzed,and which’s efficiency for predicting fetal aneuploidy was also analyzed.Results:According to the results of delivery or induced labor,34 cases with chromosomal aneuploidy were found in 2086 fetuses.In 41 fetuses with A wave inversion of fetal venous catheter were found by ultrasound examination,27(65.9%)cases with chromosomal aneuploidy were identified.In 47 fetuses with thick NT were found by ultrasound examination,28(59.5%)cases with chromosomal aneuploidy were identified.In 39 fetuses with thick NT and A wave inversion of fetal venous catheter were found by ultrasound examination,31(79.5%)cases with chromosomal aneuploidy were identified.The sensitivity(79.4%or 58.8%),the specificity(99.3%or 98.7%),the accuracy(99.0%or 98.0%),the positive predictive value(65.9%or 42.6%),and the negative predictive value(99.7%or 99.3%)of A wave inversion of venous catheter or NT thickening for diagnosing fetal chromosomal aneuploidy were all significant lower that those(91.2%,99.6%,99.5%,79.5%,and 99.9%,respectively)of A wave inversion of venous catheter combined with NT thickening(P<0.05).Conclusion:The results of A wave inversion of venous catheter combined with NT value of fetus detected by ultrasound during the first trimester of pregnancy for screening of chromosomal aneuploidy can significa

关 键 词：孕早期 胎儿染色体非整倍体异常 胎儿颈项透明层 静脉导管A波倒置 筛查效率 

分 类 号：R714.5[医药卫生—妇产科学] R440[医药卫生—临床医学]