孕妇血清β-HCG、PAPP-A联合三维超声对胎儿脊柱裂的诊断价值  

Diagnostic Value of Serum β-HCG, PAPP-A in Pregnant Women Combined with Three-Dimensional Ultrasound in Fetal Spina Bifida

作　　者：汪亚芬 刘芳 杨小风 WANG Yafen;LIU Fang;YANG Xiaofeng(Department of Obstetrics and Gynecology,Zhengzhou Central Hospital affiliated to Zhengzhou University,Zhengzhou 450007,China)

机构地区：[1]郑州大学附属郑州中心医院妇产科,河南郑州450007

出　　处：《河南医学研究》2024年第3期462-465,共4页Henan Medical Research

摘　　要：目的 分析孕妇血清β-人绒毛膜促性腺激素(β-HCG)、妊娠相关蛋白A(PAPP-A)联合三维超声对胎儿脊柱裂的诊断价值。方法 选择2020年1月至2022年1月在郑州大学附属郑州中心医院产前检查疑似胎儿脊柱裂的131例孕妇作为研究对象,收集孕妇资料。所有产妇均进行三维超声检查,以酶联免疫吸附法、化学发光法检测孕妇血清β-hCG、PAPP-A水平。绘制受试者工作特征(ROC)曲线评估血清β-HCG、PAPP-A联合三维超声对胎儿脊柱裂的诊断价值,以多因素logistic回归分析影响胎儿脊柱裂发生的因素。结果 本研究中131例疑似胎儿脊柱裂孕妇中109例确诊为脊柱裂,其中开放型脊柱裂90例,19例闭合型脊柱裂。三维超声检查显示为脊柱裂者95例,非脊柱裂者36例。脊柱裂组血清β-HCG水平高于非脊柱裂组(P<0.05),血清PAPP-A水平低于非脊柱裂组(P<0.05)。绘制ROC曲线评估血清β-HCG、PAPP-A水平联合三维超声诊断胎儿脊柱裂的价值,结果显示,三者单独检测敏感性及特异性至少为77.27%,联合检测敏感性、特异性均为95%以上,具有更高的诊断价值。多因素logistic回归分析显示,血清β-HCG、PAPP-A水平为影响胎儿脊柱裂发生的因素(P<0.05)。结论 孕期血清β-HCG、PAPP-A水平为影响胎儿脊柱裂发生的因素,与三维超声联合检测可为临床诊断胎儿脊柱裂提供重要参考价值,临床应尽早筛查以降低分娩脊柱裂新生儿的风险。Objective To analyze serumβ-human chorionic gonadotropin(β-HCG)and pregnancy-associated protein A(PAPP-A)in pregnant women diagnostic value of combined with three-dimensional ultrasound in fetal spina bifida.Methods A total of 131 pregnant women with suspected fetal spina bifida in Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2020 to January 2022 were selected as the study subjects and pregnant women were collected.All women underwent three-dimensional ultrasound to detect serumβ-hCG and PAPP-A levels by enzyme-linked immunosorbent assay and chemiluminescence.The receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of serumβ-HCG,PAPP-A combined with three-dimensional ultrasound in fetal spina bifida,and the factors affecting the occurrence of fetal spina bifida were analyzed by multivariate logistic regression.Results In this study,109 of the 131 pregnant women with suspected fetal spina bifida were diagnosed with spina bifida,including 90 cases of open spina bifida and 19 cases of closed spina bifida.Three-dimensional ultrasound showed spina bifida in 95 cases and non-spina bifida in 36 cases.The serumβ-HCG level in the spina bifida group was higher than that in the non-spina bifida group(P<0.05),and the serum PAPP-A level was lower than that in the non-spina bifida group(P<0.05).The value of drawing receiver operating characteristic curves to evaluate serumβ-HCG and PAPP-A levels combined with three-dimensional ultrasound in the diagnosis of fetal spina bifida showed that the sensitivity and specificity of the three alone detection were at least 77.27%,and the sensitivity and specificity of the combined detection were more than 95%,which had higher diagnostic value.Multivariate logistic regression analysis showed that serumβ-HCG and PAPP-A levels were factors affecting the occurrence of fetal spina bifida(P<0.05).Conclusion Serumβ-HCG and PAPP-A levels during pregnancy are the factors affecting the occurrence of fetal spina bifida,and the c

关 键 词：胎儿脊柱裂 三维超声 妊娠相关蛋白A 人绒毛膜促性腺激素 诊断 

分 类 号：R714.7[医药卫生—妇产科学]