游离β-hCG联合超声颅内透明层检测对孕中期胎儿神经管畸形的筛查价值  

The value of free-hCG detection combined with ultrasound intracranial transparent layer for screening fetal neural tube malformations during the second trimester of pregnancy

作　　者：姜亦然 王美 JIANG Yiran;WANG Mei(Shunyi Hospital of Beijing Hospital of Traditional Chinese Medicine,Beijing,101300)

机构地区：[1]北京中医医院顺义医院,101300

出　　处：《中国计划生育学杂志》2021年第6期1201-1203,共3页Chinese Journal of Family Planning

摘　　要：目的:探讨游离人绒毛膜促性腺激素β亚基(F-β-hCG)联合超声颅内透明层(IT)厚度检测对孕中期胎儿神经管畸形(NTDs)的筛查价值。方法:收集2015年7月-2019年9月本院确诊NTDs胎儿的孕妇54例为观察组,同期分娩正常胎儿孕妇68例为对照组,测定孕中期孕妇F-β-hCG、IT、颈项透明层(NT)、顶臀径(CRL),分析超声IT厚度与F-β-hCG水平的相关性,及对胎儿NTDs的筛查价值。结果:观察组超声IT厚度(1.29±0.37mm)低于对照组(1.72±0.38mm),F-β-hCG(213.61±62.64μg/L)高于对照组(124.30±39.71μg/L)(均P<0.05);超声IT厚度检测NTDs的ROC曲线下面积为0.842,截断值为1.580,敏感度为88.9%,特异性为63.2%;F-β-hCG检测NTDs的ROC曲线下面积为0.868,截断值为143.252μg/L,敏感度为87.0%,特异性为73.5%;两者联合检测NTDs的ROC曲线下面积为0.930,敏感度为94.4%,特异性为82.4%。F-β-hCG与IT、CRL呈负相关,与NT呈正相关(P<0.05)。结论:超声IT和F-β-hCG在孕中期胎儿NTDs筛查有一定价值,且联合检测筛查价值更高。Objective: To investigate the value of free beta subunit of human chorionic gonadotropin(F-β-hCG) detection combined with ultrasound intracranial translucency(IT) thickness for screening neural tube malformation(NTDs) during the second trimester of pregnancy. Methods: 54 pregnant women with confirmed NTDS fetuses were selected in observation group from July 2015 to September 2019, and 68 pregnant women with normal fetuses were selected in control group during the same period. The F-β-HCG level of the pregnant women, and the values of fetal IT and nuchal translucency(NT), and crown-rump length(CRL) during the second trimester of pregnancy were measured. The correlation between the value of fetal IT thickness by ultrasound and F-β-HCG level was analyzed. The values of fetal IT thickness by ultrasound and F-β-HCG level for screening fetal NTDS were also analyzed. Results: The ultrasonic IT thickness(1.29±0.37 mm) of the fetus in the observation group was significant lower than that(1.72±0.38 mm) of the fetus in the control group, and the F-β-HCG level(213.61±62.64μg/L) of the women in the observation group was significant higher than that(124.30±39.71μg/L) of the women in the control group(all P<0.05). The area under the ROC curve, the cut-off value, the sensitivity, and the specificity of ultrasonic IT thickness for diagnosing NTDs were 0.842, 1.580, 88.9%, and 63.2%, respectively. The area under the ROC curve, the cut-off value, the sensitivity, and the specificity of F-β-HCG level for diagnosing NTDs were 0.868, 143.252μg/L, 87.0%, and 73.5%, respectively. The area under the ROC curve, the sensitivity, and the specificity of ultrasonic IT thickness combined with F-β-HCG level for diagnosing NTDs by were 0.930, 94.4%, 82.4%, respectively. The F-β-HCG level of the women was negatively correlated with the fetal values of IT and CRL, but was positively correlated with the fetal NT value(P<0.05). Conclusion: Ultrasounic IT value of the fetus and the F-β-hCG level of the women during the second trimeste

关 键 词：产前筛查 孕中期 胎儿神经管畸形 颅内透明层 游离人绒毛膜促性腺激素β亚基 

分 类 号：R714.5[医药卫生—妇产科学]