三维超声联合血清甲胎蛋白、游离β-人绒毛膜促性腺激素检查在胎儿神经管畸形中的诊断价值  

Diagnostic value of three-dimensional ultrasound combined with serum alpha-fetoprotein and freeβ-human chorionic gonadotropin in fetal neural tube defects

作　　者：杨文娟 孙茜 王峥 YANG Wenjuan;SUN Qian;WANG Zheng(Xi'an Qinhuang Hospital,Xi'an 710600;Xi'an People's Hospital/Xi'an Fourth Hospital,Xi'an 710004,China)

机构地区：[1]西安秦皇医院,陕西西安710600 [2]西安市人民医院/西安市第四医院,陕西西安710004

出　　处：《临床医学研究与实践》2023年第33期51-54,共4页Clinical Research and Practice

基　　金：陕西省重点研发计划项目(No.2017SF-159)。

摘　　要：目的探讨三维超声联合血清甲胎蛋白(AFP)、游离β-人绒毛膜促性腺激素(Fβ-HCG)检查在胎儿神经管畸形中的诊断价值。方法选取2018年1月至2021年1月在西安市第四医院产科进行规律产检的3650名孕妇作为研究对象。孕妇均接受血清AFP、Fβ-HCG及三维超声检查。统计引产后或产后检查结果,分析神经管畸形胎儿的影像学表现。以引产后或产后检查结果为金标准,比较三维超声、血清AFP、Fβ-HCG及联合检查对神经管畸形的诊断效能。比较神经管畸形和非神经管畸形胎儿的母体血清AFP、Fβ-HCG水平。结果引产后或产后检查结果证实,3650名胎儿中,35例为胎儿神经管畸形,发生率为0.96%(35/3650)。联合检查诊断神经管畸形的灵敏度、特异度及准确度均高于各单项检查(P<0.05)。神经管畸形胎儿的母体血清AFP、Fβ-HCG水平高于非神经管畸形,差异具有统计学意义(P<0.05)。结论三维超声联合血清AFP、Fβ-HCG检查在胎儿神经管畸形中具有较好的诊断价值。Objective To explore the diagnostic value of three-dimensional ultrasound combined with serum alpha-fetoprotein(AFP)and freeβ-human chorionic gonadotropin(Fβ-HCG)in fetal neural tube defects.Methods A total of 3650 pregnant women who underwent regular prenatal examination in the obstetrics department of the Xi'an Fourth Hospital from January 2018 to January 2021 were selected as the research objects.All pregnant women received serum AFP,Fβ-HCG and three-dimensional ultrasound examination.The results of induced labor or postpartum examination were statistically analyzed,and the imaging findings of fetal neural tube defects were analyzed.The diagnostic efficacy of three-dimensional ultrasound,serum AFP,Fβ-HCG and combined examination for neural tube defects were compared with the results of induced labor or postpartum examination as the gold standard.The levels of maternal serum AFP and Fβ-HCG of fetuses with neural tube defects and non-neural tube defects were compared.Results The results of induced labor or postpartum examination confirmed that 35 of the 3650 fetuses were fetal neural tube defects,with an incidence of 0.96%(35/3650).The sensitivity,specificity and accuracy of combined examination in the diagnosis of neural tube defects were higher than those of each single examination(P<0.05).The maternal serum AFP and Fβ-HCG levels in the fetuses with neural tube defects were higher than those in the non-neural tube defects,and the differences were statistically significant(P<0.05).Conclusion Three-dimensional ultrasound combined with serum AFP and Fβ-HCG examination has a good diagnostic value in fetal neural tube defects.

关 键 词：三维超声 甲胎蛋白 游离β-人绒毛膜促性腺激素 神经管畸形 

分 类 号：R714[医药卫生—妇产科学]