超声心动图联合孕妇血清脑钠肽和同型半胱氨酸检测对胎儿先天性心脏病的诊断效能  

Diagnostic value of echocardiography combined with maternal serum brain natriuretic peptide and homocysteine in fetal congenital heart disease

作　　者：龚英伟 任凯媚 赵璐[1] GONG Yingwei;REN Kaimei;ZHAO Lu(Authors'address:Department of Ultrasound,Lishui People's Hospital,Lishui 323000,China)

机构地区：[1]丽水市人民医院超声科,323000

出　　处：《心电与循环》2023年第4期358-361,共4页Journal of Electrocardiology and Circulation

摘　　要：目的 探究超声心动图联合孕妇血清脑钠肽(BNP)和同型半胱氨酸(Hcy)对胎儿先天性心脏病的诊断效能。方法 选择2019年1月至2022年4月在丽水市人民医院进行产检的孕妇128例,其中胎儿患先天性心脏病的孕妇63例为观察组,胎儿健康的孕妇65例为对照组。检测两组孕妇血清BNP和Hcy水平。采用logistic回归、ROC曲线分析超声心动图联合孕妇血清BNP和Hcy水平对胎儿先天性心脏病的诊断效能。结果 观察组孕妇血清BNP和Hcy水平[(29.4±6.8)pg/m L、(20.3±3.9)μmol/m L]高于对照组[(17.7±5.9)pg/m L、(8.7±2.6)μmol/m L],差异均有统计学意义(均P<0.05)。logistic回归分析显示,孕妇血清BNP和Hcy水平升高是胎儿先天性心脏病的危险因素(OR=3.17、2.64,95%CI:1.27~7.90、1.36~5.11)。超声心动图联合孕妇血清BNP和Hcy水平的诊断灵敏度为0.83,特异度为0.86,AUC为0.703,约登指数为0.69,高于超声心动图、BNP和Hcy单独诊断结果。结论 超声心动图联合孕妇血清BNP和Hcy检测对于诊断胎儿先天性心脏病有良好的诊断效能。Objective To explore the diagnostic value of echocardiography combined with maternal serum brain natriuretic peptide(BNP)and homocysteine(Hcy)in fetal congenital heart disease.Methods A total of 128 pregnant women undergoing prenatal examination in Lishui People's Hospital between January 2019 and April 2022 were included.Among them,63 pregnant women had fetuses with congenital heart disease(observation group)and 65 pregnant women had healthy fetuses(control group).Maternal serum BNP and Hcy were measured in both groups.Logistic regression and ROC curve were used to analyze the diagnostic efficacy of echocardiography combined with maternal serum BNP and Hcy in fetal congenital heart disease.Results Maternal serum BNP and Hcy were significantly higher in the observation group[(29.4±6.8)pg/mL、(20.3±3.9)μmol/mL]than in the control group[(17.7±5.9)pg/mL、(8.7±2.6)μmol/mL,all P<0.05].Logistic regression analysis showed that elevated serum BNP(OR=3.17,95%CI:1.27-7.90)and Hcy(OR=2.64,95%CI:1.36-5.11)were risk factors for fetal congenital heart disease.The diagnostic sensitivity,specificity,AUC and Youden index of echocardiography combined with maternal serum BNP and Hcy were 0.83,0.86,0.703 and 0.69,respectively,which was higher than separately diagnostic results of echocardiography,BNP and Hcy.Conclusion Echocardiography combined with maternal serum BNP and Hcy has a better diagnostic efficacy in detecting fetal congenital heart disease.

关 键 词：超声心动图 脑钠肽 同型半胱氨酸 胎儿 先天性心脏病 

分 类 号：R714.5[医药卫生—妇产科学]