超声颅脑冠状切面鼻尖偏斜法联合母体血清标志物筛查在胎儿颜面部畸形中的应用价值  

The application value of ultrasonic craniocerebral coronal section nose tip deviation method combined with maternal serum marker screening in fetal facial deformity

作　　者：韩丽[1] 潘辑[1] 唐屹青 柳标[1] HAN Li;PAN Ji;TANG Yiqing;LIU Biao(Department of Ultrasound,Suzhou Jiulong Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Suzhou,Jiangsu 215000,China)

机构地区：[1]上海交通大学医学院附属苏州九龙医院超声科,江苏苏州215000

出　　处：《中国优生与遗传杂志》2022年第7期1215-1219,共5页Chinese Journal of Birth Health & Heredity

基　　金：江苏省优势学科建设工程项目(YSHL0813-26)。

摘　　要：目的探究超声颅脑冠状切面鼻尖偏斜法联合母体血清标志物筛查在胎儿颜面部畸形中的应用价值。方法选取上海交通大学医学院附属苏州九龙医院产前筛查疑似胎儿颜面部畸形孕中期孕妇92例,均行超声颅脑冠状切面鼻尖偏斜法及血清游离β-人绒毛膜促性腺激素(β-hCG)、甲胎蛋白(AFP)、游离雌三醇(uE_(3))检查,以引产或分娩结果为诊断“金标准”,统计分析超声颅脑冠状切面鼻尖偏斜法、母体血清标志物诊断胎儿颜面部畸形的诊断效能。结果本研究92例孕中期孕妇中53例经引产及分娩结果证实为胎儿颜面部畸形,孕妇年龄、孕前叶酸服用时间、不良妊娠史、孕期用药史、孕中期血清游离β-hCG、AFP、uE_(3)水平均为胎儿颜面部畸形发生的关联性因素(P<0.05);孕中期超声颅脑冠状切面鼻尖偏斜法、血清游离β-hCG、AFP、uE_(3)水平联合诊断胎儿颜面部畸形的曲线下面积(AUC)为0.931。结论孕中期超声颅脑冠状切面鼻尖偏斜法联合母体血清标志物游离β-hCG、AFP、uE_(3)能明显提高胎儿颜面部畸形诊断准确率,可作为胎儿颜面部畸形筛查的可靠方法。Objective To explore the application value of the nasal tip deviation method on the coronal section of the ultrasound brain combined with the screening of maternal serum markers in the screening of fetal facial deformities. Methods A total of 92 pregnant women in the second trimester of pregnancy with suspected fetal facial deformity were selected for prenatal screening in Suzhou Kowloon Hospital, affiliated to Shanghai Jiao Tong University School of Medicine. β-hCG,alpha-fetoprotein(AFP), free estriol(uE_(3)) examination, with the results of labor induction or delivery as the “gold standard”for diagnosis, statistical analysis of ultrasound craniocerebral coronal section nose tip deviation method, maternal serum markers for diagnosis diagnostic efficacy of fetal facial deformities. Results Among the 92 pregnant women in the second trimester of this study, 53 cases were confirmed to have fetal facial deformity by induction and delivery results. Maternal age,pre-pregnancy folic acid intake time, adverse pregnancy history, medication history during pregnancy, serum free β-hCG, AFP,uE_(3) levels were all related factors for the occurrence of fetal facial deformities(P<0.05). The second trimester ultrasound craniocerebral coronal section nose tip deviation method, serum free β-hCG, AFP, uE_(3) levels combined to diagnose fetal facial deformities under the curve the area(AUC) was 0.931. Conclusion The nasal tip deflection method of coronal section of ultrasound in the second trimester of pregnancy combined with maternal serum markers free β-hCG, AFP and uE_(3) can significantly improve the diagnostic accuracy of fetal facial deformity, and can be used as a reliable method for fetal facial deformity screening.

关 键 词：胎儿 颜面部畸形 超声 颅脑冠状切面鼻尖偏斜法 母体血清标志物 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]