3D-CDU检查联合母体血清VitB12、AFP、叶酸在孕中期胎儿神经管畸形筛查中的临床价值  

The clinical value of 3D-CDU examination combined with the detection of maternal serum Vit B12,AFP and folic acid in the screening of fetal neural tube defects in the second trimester

作　　者：张会芳 李冠楠 蔡丽娜 ZHANG Huifang;LI Guannan;CAI Lina(Department of Obstetrics and Gynecology,Affiliated Hospital of Chifeng College,Inner Mongolia,Chifeng 024000,China)

机构地区：[1]赤峰学院附属医院妇产科,内蒙古自治区赤峰市024000

出　　处：《河北医药》2022年第2期214-217,共4页Hebei Medical Journal

基　　金：内蒙古自治区自然科学基金项目[编号:2018MS(LH)0811]。

摘　　要：目的探讨三维彩色多普勒超声成像(3D-CDU)检查联合母体血清维生素B12(VitB12)、甲胎蛋白(AFP)、叶酸在孕中期胎儿神经管畸形(NTDs)筛查中的临床价值。方法选取2018年1月至2020年6月收治的102例孕中期疑似胎儿NTDs,均行3D-CDU检查,并检测母体血清VitB12、AFP、叶酸水平,以引产或分娩结果作为金标准,分析3D-CDU检查结果及胎儿NTDs影像学表现。根据金标准结果分为发生组(n=23)和未发生组(n=79),对比2组母体血清VitB12、AFP、叶酸水平,分析3D-CDU检查结果与母体血清VitB12、AFP、叶酸水平的关系,评价3D-CDU检查、母体血清VitB12、AFP、叶酸单独及联合诊断价值。结果经引产或分娩结果证实,102例孕中期疑似胎儿NTDs中胎儿NTDs发生率为22.55%。102例孕中期疑似胎儿NTDs中,3D-CDU检查阳性24例,其中无脑畸形5例、脑积水7例、脊柱裂11例、脑及脑膜膨出1例。发生组母体血清VitB12、叶酸低于未发生组,AFP高于未发生组(P<0.05)。3D-CDU检查阳性与母体血清VitB12、叶酸呈负相关,与AFP呈正相关(P<0.05)。3D-CDU检查、母体血清VitB12、AFP、叶酸联合诊断曲线下面积(AUC)最大,为0.962,敏感度、特异度分别为95.65%、92.41%。结论3D-CDU联合母体血清VitB12、AFP、叶酸水平检测可为临床筛查孕中期胎儿NTDs、提高出生人口质量提供一种有效新手段。Objective To investigate the clinical value of three-dimensional color Doppler ultrasonography(3D-CDU)combined with the detection of maternal serum vitamin B12(Vit B12),alpha-fetoprotein(AFP)and folic acid in the screening of fetal neural tube defects(NTDs)in the second trimester.Methods A total of 102 fetus with suspected NTDs in the second trimester of pregnancy whose mothers were hospitalized in our hospital from January 2018 to June 2020 were enrolled in the study.The 3D-CDU examination was performed,and maternal serum levels of VitB12,AFP,and folic acid levels were detected.The results of induction or delivery were taken as gold standard,and 3D-CDU examination results and fetal NTDs imaging findings were analyzed.According to the above results,these pregnant women were divided into occurrence group(n=23)and non-occurrence group(n=79).The maternal serum levels VitB12,AFP,and folic acid were compared between the two groups.Moreover the correlation between the results of 3D-CDU examination and maternal serum levels of VitB12,AFP,and folic acid levels was analyzed,and the diagnostic value of simple 3D-CDU examination and combined detection with maternal serum levels VitB12,AFP,and folic acid in diagnosis of NTDs was evaluated.Results Of the 102 cases of suspected fetal NTDs in the second trimester,the incidence rate of NTDs was 22.55%,and 24 cases were positive by 3D-CDU examination,including 5 cases of anencephaly,7 cases of hydrocephalus,11 cases of spina bifida,and 1 case of cerebral and meningocele.The maternal serum levels of VitB12 and folic acid in occurrence group were significantly lower than those in non-occurrence group,however,AFP levels were significantly higher than those in non-occurrence group(P<0.05).The area under the curve(AUC)of combined diagnosis of 3D-CDU examination with the detection of maternal serum levels VitB12,AFP,and folic acid was the largest(0.962),and the sensitivity and specificity were 95.65%and 92.41%,respectively.Conclusion 3D-CDU examination combined with the detection of ma

关 键 词：三维彩色多普勒超声成像 维生素B12 甲胎蛋白 叶酸 孕中期 胎儿神经管畸形 

分 类 号：R714.5[医药卫生—妇产科学]