B超联合母体血清甲胎蛋白、游离β-hCG、游离雌三醇检测对胎儿中枢神经系统畸形的诊断价值分析  

Diagnostic Value of Ultrasound Combined with Maternal Serum Alpha-fetoprotein,Freeβ-hCG and Free Estriol Tests for Fetal Central Nervous System Malformations

作　　者：蒋胜男 JIANG Sheng-nan(Henan Shenhua Group General Hospital,Yongcheng,Henan,476600,China)

机构地区：[1]河南神火集团总医院,河南永城476600

出　　处：《黑龙江医学》2022年第23期2839-2841,共3页Heilongjiang Medical Journal

基　　金：河南省医学科技攻关计划(LHGJ20191403)。

摘　　要：目的:探讨B超联合母体血清甲胎蛋白(AFP)、游离β-hCG (Freeβ-hCG)、游离雌三醇(uE3)检测对胎儿中枢神经系统畸形的诊断价值。方法:选取2019年3月—2020年6月在河南神火集团总医院接受孕期检查的253例孕妇作为研究对象,所有孕妇均在孕16~21周接受三维超声检查。同时,取母体血分离血清,检测AFP、Freeβ-hCG、uE3进行胎儿中枢神经系统畸形的筛查,探讨三维超声、血清AFP、Freeβ-hCG、uE3联合检测在胎儿中枢神经系统畸形中的诊断效能。结果:超声检出中枢神经系统畸形率为0.99%,血清指标检出中枢神经系统畸形率为1.26%,差异无统计学意义(P>0.05);以无创DNA与随访结果为金标准,超声联合血清AFP、Freeβ-hCG、uE3的敏感性、特异性分别为93.75%、99.52%。结论:B超联合母体血清AFP、Freeβ-hCG、uE3检测在胎儿中枢神经系统畸形诊断中具有较高的敏感性、特异性及准确性,该方法在临床上的应用可以降低误诊漏诊风险,对孕中期检查和人口质量的提高有显著性意义。Objective:To investigate the diagnostic value of ultrasound combined with maternal serum alpha-fetoprotein(AFP),free beta-hCG(Free β-hCG) and free estriol(uE3) tests on fetal central nervous system malformations.Methods:253 pregnant women who underwent pregnancy checkups in hospitals from March 2019 to June 2020 were selected for the study, and all of them received 3D ultrasound examinations at 16 to 21 weeks of gestation. Maternal blood was collected to isolate serum for AFP,Freeβ-hCG, and uE3 for screening of fetal central nervous system malformations. The diagnostic efficacy of combined 3D ultrasound, serum AFP, Freeβ-hCG, and uE3 testing in fetal central nervous system malformations was explored.Results:The rate of CNS malformations detected by ultrasound was 0.99%, and the rate of CNS malformations detected by serum indicators was 1.26%,with no statistically significant difference(P>0.05). The sensitivity and specificity of ultrasound combined with serum AFP,Freeβ-hCG, and uE3 were 93.75% and 99.52%, with noninvasive DNA and follow-up results as the gold standard.Conclusion:Ultrasound combined with maternal serum AFP, Freeβ-hCG and uE3 testing has high sensitivity, specificity and accuracy in the diagnosis of fetal central nervous system malformations. The application of this method in clinical practice can reduce the risk of misdiagnosis and omission and has significant positive implications for mid-pregnancy screening and population quality.

关 键 词：B超 胎儿 中枢神经系统 畸形 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学]