多模态超声成像联合母体血清AFP、F-β-HCG水平对胎儿中枢神经系统畸形的诊断价值分析  

Diagnostic value of multimodal ultrasound imaging combined with maternal serum AFP and F-β-HCG levels for fetal central nervous system malformation

作　　者：古力斯坦·卡迪尔 娜菲莎·艾力 古力加哪提·吾斯曼 周敏[1] 张利[1] Gulisitan·KARDIER;Nafeisha·AILI;Gulijianeti·WUSIMAN;ZHOU Min;ZHANG Li(Department of Ultrasonography,The People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Urumqi 830001,China;Department of Ultrasonic Diagnosis,General Hospital of Xinjiang Military Region,Xinjiang Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院超声科,新疆乌鲁木齐830001 [2]新疆军区总医院超声诊断科,新疆乌鲁木齐830000

出　　处：《中国妇幼健康研究》2022年第8期120-124,共5页Chinese Journal of Woman and Child Health Research

基　　金：新疆维吾尔自治区自然科学基金(编号:2019D01C115)。

摘　　要：目的 分析多模态超声成像联合母体血清甲胎蛋白(AFP)、游离-β-人绒毛膜促性腺激素(F-β-HCG)水平对胎儿中枢神经系统畸形的诊断价值。方法 选取2019年1月至2020年6月本院接收的148例可疑孕早期单胎胎儿中枢神经系统畸形的孕妇为研究对象,进行多模态超声成像检查,并检测其血清AFP、F-β-HCG水平。记录随访资料,以尸检或新生儿检查的结果为“金标准”,统计胎儿中枢神经系统畸形结果;观察畸形者母体多模态超声检出情况,对比畸形者和发育正常者母体血清AFP、F-β-HCG水平;绘制受试者工作特征(ROC)曲线,分析多模态超声成像联合母体血清AFP、F-β-HCG水平对胎儿中枢神经系统畸形的诊断价值。结果 “金标准”结果显示,148例胎儿中共有25例患中枢神经系统畸形(16.89%),其中有15例经多模态超声成像检查拟诊出,经检验多模态超声成像检出情况与“金标准”结果一致性良好(Kappa=0.874,P<0.05)。胎儿中枢神经系统畸形者母体血清AFP、F-β-HCG水平均高于胎儿中枢神经系统发育正常者母体(U值分别是28.449、18.612,P<0.05)。多模态超声成像与母体血清AFP、F-β-HCG水平联合诊断胎儿中枢神经系统畸形的灵敏度(96.00%)和曲线下面积(AUC=0.928)均高于单独诊断(P<0.01),特异度与单独诊断比较无统计学差异(P>0.05)。结论 发生胎儿中枢神经系统畸形的孕妇多模态超声成像有明显表现,且其血清AFP、F-β-HCG水平均高于未发生胎儿中枢神经系统畸形的孕妇。多模态超声成像联合母体血清AFP、F-β-HCG水平对胎儿中枢神经系统畸形的诊断价值较高,优于单独诊断。Objective To analyze diagnostic value of multimodal ultrasound imaging combined with maternal serum levels of alpha fetoprotein(AFP) and free-β-human chorionic gonadotropin(F-β-HCG) for fetal central nervous system malformation.Methods 148 pregnant women with singleton fetus with suspected fetal central nervous system malformation in the first trimester of pregnancy who admitted to our hospital from January 2019 to June 2020 were selected as study subjects.They received multimodal ultrasound imaging examination, and their serum AFP and F-β-HCG levels were detected.The follow-up data were recorded, and the results of autopsy or neonatal examination were recorded as “gold standard”,and the results of fetal central nervous system malformation was summed up.The maternal multimodal ultrasound imaging was analyzed, and serum AFP and F-β-HCG levels of the pregnant women with fetal central nervous system malformation were compared with those of the pregnant women with normal fetus.The receiver operating characteristic(ROC) curve was drawn to analyze diagnostic value of multimodal ultrasound imaging combined with maternal serum AFP and F-β-HCG levels for fetal central nervous system malformations.Results The “gold standard” results showed that among 148 fetuses(16.89%),there were 25 cases of fetal central nervous system malformation, among which, there were 15 cases diagnosed by multimodal ultrasound imaging, and the result of multimodal ultrasound imaging was in good agreement with the results of the “gold standard”(Kappa=0.874,P<0.05).The serum AFP and F-β-HCG levels of the pregnant women with malformed fetal central nervous system were higher than those of the pregnant women with normal fetal central nervous system(U=28.449 and 18.612 respectively, both P<0.05).The sensitivity(96.00%) and area under the curve(AUC=0.928) of multimodal ultrasound imaging combined with maternal serum AFP and F-β-HCG levels for diagnosing fetal central nervous system malformation were higher than those of single diagnosi

关 键 词：多模态超声成像 甲胎蛋白 游离-β-人绒毛膜促性腺激素 中枢神经系统 胎儿畸形 

分 类 号：R174.6[医药卫生—妇幼卫生保健]