NT增厚、静脉导管A波倒置联合PAPP-A阳性在孕11~14周胎儿染色体异常筛查中的应用价值  

Application value of NT thickening,ductus venous A wave inversion combined with PAPP-A positive in the screening of fetal chromosomal abnormalities in pregnancy 11-14 weeks

作　　者：孙文莉 王颖金 SUN Wenli;WANG Yingjin(Medical Ultrasound Center,Northwest Women's and Children's Hospital,Xi'an 710061,China)

机构地区：[1]西北妇女儿童医院医学超声中心,陕西西安710061

出　　处：《临床医学研究与实践》2022年第15期103-105,共3页Clinical Research and Practice

基　　金：陕西省科学技术研究发展计划项目(No.2010K15-06-02)。

摘　　要：目的研究颈部透明层(NT)增厚、静脉导管(DV)A波倒置联合妊娠相关血浆蛋白A(PAPP-A)阳性在孕11~14周胎儿染色体异常(CA)筛查中的应用价值。方法纳入孕11~14周的孕妇3220例,均随访至引产或分娩,记录胎儿遗传学诊断结果。以遗传学诊断结果为金标准,分析NT增厚、DV A波倒置、PAPP-A阳性对CA的诊断价值。用ROC曲线分析NT增厚联合DV A波倒置、NT增厚联合PAPP-A阳性、DV A波倒置联合PAPP-A阳性及三项联合对CA的诊断价值。结果3220例孕妇中,CA 56例,NT增厚、DV A波倒置及PAPP-A阳性均对21-三体、18-三体、性染色体异常、Turner综合征和染色体结构异常有一定的检出率。三项联合诊断的灵敏度、AUC高于两两联合诊断(P<0.05)。结论与单独诊断和两两联合诊断相比,NT增厚、DV A波倒置、PAPP-A阳性联合对孕11~14周胎儿CA的诊断价值更高,推荐用于胎儿CA的早期筛查中。Objective To study the application value of nuchal translucency(NT)thickening,ductus venous(DV)A wave inversion combined with pregnancy-associated plasma protein A(PAPP-A)positive in the screening of fetal chromosomal abnormalities(CA)in pregnancy 11-14 weeks.Methods A total of 3220 pregnant women in pregnancy 11-14 weeks were included.They were followed up until labor induction or delivery,and the fetal genetic diagnosis results were recorded.Using genetic diagnosis results as the gold standard,the diagnostic value of NT thickening,DV A wave inversion and PAPP-A positive for CA were analyzed.The ROC curve was used to analyze the diagnostic value of NT thickening combined with DV A wave inversion,NT thickening combined with PAPP-A positive,DV A wave inversion combined with PAPP-A positive and the three combinations for CA.Results Among the 3220 pregnant women,56 cases of CA,NT thickening,DV A wave inversion and PAPP-A positive had certain detection rates for 21-trisomy,18-trisomy,sex chromosome abnormality,Turner syndrome and chromosome structural abnormalities.The sensitivity and AUC of the three combined diagnosis were higher than those of the two combined diagnosis(P<0.05).Conclusion Compared with separate diagnosis and two combined diagnosis,combination of NT thickening,DV A wave inversion and PAPP-A positive has a higher diagnostic value for fetal CA in pregnancy 11-14 weeks,and it is recommended to be used in the early screening of fetal CA.

关 键 词：颈部透明层 妊娠相关血浆蛋白A 染色体异常 

分 类 号：R596.1[医药卫生—内科学]