产前超声筛查NT联合血清甲胎蛋白检测在胎儿先天性发育畸形中的应用研究  

Application of prenatal ultrasound screening NT combined with serum alpha-fetoprotein detection in fetal congenital malformation

作　　者：王瑞 张令鹏 樊昊 WANG Rui;ZHANG Lingpeng;FAN Hao(Department of Ultrasound Medicine,Jining City Yanzhou District People's Hospital,Jining,Shandong 272100,China)

机构地区：[1]济宁市兖州区人民医院超声医学科,山东济宁272100

出　　处：《影像研究与医学应用》2023年第5期15-17,共3页Journal of Imaging Research and Medical Applications

基　　金：社会民生及乡村振兴类(含医疗卫生)产前超声筛查NT检测在胎儿先天性发育畸形中的应用研究(2022YZYL105)。

摘　　要：目的:探讨产前超声筛查颈项透明层(nuchal translucency,NT)联合血清甲胎蛋白检测在胎儿先天性发育畸形中的应用价值。方法:选取2022年1—6月在济宁市兖州区人民医院进行产前检查的250例孕妇,均接受超声筛查NT及甲胎蛋白检测。以随访至妊娠结局或选择终止妊娠,检查引产结果为金标准,分析超声筛查NT、甲胎蛋白检测的价值及与妊娠或引产结果的一致性和诊断价值。结果:236例孕妇随访至妊娠结局,其中1例为室间隔缺损患儿,其余均为健康新生儿;另14例选择终止妊娠,通过引产结果发现胎儿均为先天性发育畸形;正常胎儿与发育畸形胎儿NT大小差异有统计学意义(P<0.05);正常与异常孕妇血清甲胎蛋白含量差异有统计学意义(P<0.05);超声筛查NT、血清甲胎蛋白及联合检查对胎儿先天性发育畸形的诊断准确率分别为98.00%、96.80%、99.60%;超声筛查NT联合血清甲胎蛋白检测结果与妊娠或引产结果一致性极好(Kappa=0.849、0.924),血清甲胎蛋白检测结果与妊娠或引产结果一致性中等(Kappa=0.697);超声筛查NT、甲胎蛋白及联合检测胎儿先天性发育畸形的曲线下面积(area under the curve,AUC)分别为0.896、0.827、0.967,联合检测诊断价值较高。结论:孕妇早期产前接受超声筛查NT联合甲胎蛋白检测对胎儿先天性发育畸形的诊断价值较高,有助于降低先天性发育畸形胎儿出生率。Objective To explore the value of prenatal ultrasound screening of nuchal translucency(NT)combined with serum alpha-fetoprotein(AFP)detection in the diagnosis of fetal congenital malformations.Methods 250 pregnant women who underwent prenatal examination in Jining City Yanzhou District People's Hospital from January to June 2022 were selected,and all of them underwent ultrasound screening NT and AFP detection.The value of ultrasound screening NT and AFP detection,as well as the consistency and diagnostic value with the results of pregnancy or induced labor were analyzed based on the gold standard of follow-up to pregnancy outcome or termination of pregnancy and induced labor.Results 236 pregnant women were followed up to the pregnancy outcome.Among them,1 was a child with ventricular septal defect,the rest were healthy newborns;Another 14 cases choose to terminate pregnancy.The results of induced labor showed that the fetus was congenital developmental malformation;There was statistically significant difference in NT between normal fetus and developmental malformation fetus(P<0.05);The difference of serum alpha-fetoprotein content between normal and abnormal pregnant women was statistically significant(P<0.05);The diagnostic accuracy of NT,serum alpha-fetoprotein and combined examination for fetal congenital malformation was 98.00%,96.80%and 99.60%respectively;The results of ultrasound screening NT combined with serum alpha-fetoprotein detection were in excellent agreement with pregnancy or induced labor(Kappa=0.849,0.924),and the results of serum alpha-fetoprotein detection were in moderate agreement with pregnancy or induced labor(Kappa=0.697);The area under the curve(AUC)of NT,alpha-fetoprotein and combined detection of fetal congenital malformation were 0.896,0.827 and 0.967 respectively,and the combined detection was of high diagnostic value.Conclusion NT combined with alpha-fetoprotein detection is of high diagnostic value for fetal congenital malformation,which is helpful to reduce the birth rate of congen

关 键 词：胎儿先天性发育畸形 产前筛查 颈项透明层 

分 类 号：R445.1[医药卫生—影像医学与核医学]