胎儿NT联合血清PAPP-A、ADAM12检测在唐氏综合征产前筛查中的临床应用  

The appplication value of the combination detection of fetal NT and serum PAPP-A,ADAM12 in the prenatal screening of DS

作　　者：邵菊 姜智明 林燕 SHAO Ju;JIANG Zhi-ming;LIN Yan(Department of Ultrasound,The Sixth People′s Hospital of Nantong,Nantong Jiangsu 226000,China)

机构地区：[1]江苏省南通市第六人民医院超声科,226000

出　　处：《蚌埠医学院学报》2021年第2期248-251,共4页Journal of Bengbu Medical College

摘　　要：目的:分析胎儿颈部半透明层厚度(NT)超声联合血浆相关蛋白A(PAPP-A)、解整合素-金属蛋白酶12(ADAM12)检测在唐氏综合征(DS)产前筛查的临床价值。方法:选取323名接受早期孕检的孕妇作为研究对象,所有产妇于孕11~14周行B超检查NT,并在孕15~21周行血清PAPP-A、ADAM12检测,比较NT、PAPP-A、ADAM12单项检测及联合检测DS的结果。结果:NT检测结果显示高危孕妇15例,血清PAPP-A检测高危孕妇19例,血清ADAM12检测高危孕妇20例,NT联合血清PAPP-A及ADAM12检测高危孕妇6例,其中NT检测漏诊2例,PAPP-A检测漏诊2例,血清ADAM12检测漏诊1例。NT联合PAPP-A及ADAM12诊断的敏感度、准确度、特异度、阴性预测值、阳性预测值显著高于NT、血清PAPP-A、ADAM12单独检测(P<0.05)。NT、血清PAPP-A及ADAM12单独检测及联合检测的ROC曲线下面积分别为0.802、0.729、0.762、0.905,联合检测的ROC曲线面积高于NT、血清PAPP-A及ADAM12单独检测(P<0.05)。结论:采用NT联合血清PAPP-A、ADAM12检测产前筛查DS可明显提升其检出率,具有很好的临床应用价值。Objective:To explore of the clinical value of transthoracic thickness(NT)ultrasound combined with levels of plasma associated protein A(PAPP-A)and disintegrin-metalloproteinase 12(ADAM12)in the prenatal screening of Down′s syndrome(DS).Methods:Three hundred and twenty-three women with pregnancy 11 to 14 weeks were examined using B-ultrasound,and the serum levels of PAPP-A and ADAM12 at 15 to 21 weeks of gestation were measured.The results between the single detection of NT,PAPP-A and ADAM12,and combination detection of NT,PAPP-A and ADAM12 in the diagnsois of DS were compared.Results:Fifteen,19,20 and 6 high-risk pregnant women were identified using the single detection of NT,PAPP-A and ADAM12,and combination detection of NT,PAPP-A and ADAM12,respectively.Two,2 and 1 cases were missed diagnosis using the detetcion of NT,PAPP-A and ADAM12,respectively.The sensitivity,accuracy,specificity,negative predictive value and positive predictive value of the combination detection of NT,PAPP-A and ADAM12 were significantly higher than those of single of NT,serum PAPP-A and ADAM12(P<0.05).The areas under the ROC of the single detection of NT,serum PAPP-A and ADAM12,and combination detection were 0.802,0.729,0.762 and 0.905,respectively.The ROC curve area of the combination detection was significantly higher than that of single detetcion of NT,serum PAPP-A and ADAM12(P<0.05).Conclusions:The combination detection of NT,serum PAPP-A and ADAM12 can significantly improve the detection rate of DS,and has good clinical value.

关 键 词：唐氏综合征 颈部半透明层厚度 血浆相关蛋白A 解整合素-金属蛋白酶12 

分 类 号：R714.5[医药卫生—妇产科学]