孕中期母体血清F-β-HCG、VB12、Hcy水平、四维彩超联合检测对胎儿中枢神经系统畸形(CNS)的诊断价值  

Diagnostic Value of Maternal Serum F-β-HCG,VB12,Hcy Levels in the Second Trimester Combined with Four-dimensional Color Ultrasound in Fetal Central Nervous System Malformations (CNS)

作　　者：朱会玲 刘华 王晓莹 ZHU Huiling;LIU Hua;WANG Xiaoying(Department of Ultrasound,Luoyang Mudan Obstetrics and Gynecology Hospital,Luoyang 471000,Henan,China)

机构地区：[1]洛阳牡丹妇产医院超声科,河南洛阳471000 [2]新乡市中心医院超声科,河南新乡453000 [3]黄河三门峡医院超声科,河南三门峡472000

出　　处：《航空航天医学杂志》2024年第6期641-644,共4页Journal of Aerospace medicine

基　　金：LHGJ20211733河南省医学科技攻关联合共建项目。

摘　　要：目的 探究孕中期四维彩超联合母体血清维生素B12(VB12)、游离-β-人绒毛膜促性腺激素(F-β-HCG)、同型半胱氨酸(Hcy)水平检测对胎儿中枢神经系统畸形(CNS)的诊断价值。方法 选取2021年07月~2023年08月于我院就诊的78例疑似胎儿CNS孕妇,以生产结局为金标准,统计生产结局、四维彩超结果,并分析四维彩超诊断效能,比较发生CNS与正常者母体血清Hcy、VB12、F-β-HCG水平,效能分析采用受试者(ROC)曲线。结果 四维彩超诊断灵敏度、准确度分别为86.67%、94.87%,漏诊率为13.33%;发生胎儿CNS的母体血清F-β-HCG、Hcy水平均高于正常者(P<0.05);母体血清VB12水平低于正常者(P<0.05);母体血清维生素B12、F-β-HCG、Hcy水平、四维彩超联合诊断胎儿CNS的AUC为0.962,最佳预测敏感度、特异度分别为93.33%、85.71%,均高于单独诊断。结论 四维彩超联合母体血清维生素B12、F-β-HCG、Hcy水平诊断可作为筛查CNS的辅助指标,具有较高的诊断灵敏度,可为临床及时诊断,终止妊娠,避免畸形新生儿提供可靠依据。Objective To explore the diagnostic value of maternal serum vitamin B12(VB12),free-β-human chorionic gonadotropin(F-β-HCG) and homocysteine(Hcy) levels in the second trimester of pregnancy combined with four-dimensional color ultrasound in fetal central nervous system malformations(CNS).Methods A total of 78 pregnant women with suspected fetal CNS who were admitted to our hospital from July 2021 to August 2023 were selected.With the birth outcome as the gold standard,the birth outcome and results of 4-D color Doppler ultrasound were analyzed,and the diagnostic efficiency of 4-D color Doppler ultrasound was compared.Serum levels of Hcy,VB12 and F-β-HCG in normal CNS patients were compared,and ROC curve was used for efficacy analysis.Results The diagnostic sensitivity and accuracy of 4D color ultrasound were 86.67% and 94.87% respectively,and the missed diagnosis rate was 13.33%.The levels of maternal serum F-β-HCG and Hcy were higher than normal(P<0.05),and the levels of maternal serum VB12 were lower than normal(P<0.05).The AUC of maternal serum vitamin B12,F-β-HCG,Hcy levels,and four-dimensional color Doppler ultrasound for the combined diagnosis of fetal CNS was 0.962,and the best predictive sensitivity and specificity were 86.67% and 95.24%,respectively.Conclusions 4D color ultrasound combined with maternal serum vitamin B12,F-β-HCG and Hcy levels can be used as a sensitive screening for CNS,providing a reliable basis for timely clinical diagnosis,termination of pregnancy and avoidance of malformed newborns.

关 键 词：四维彩超 血清维生素B12 游离-β-人绒毛膜促性腺激素 同型半胱氨酸 胎儿中枢神经系统畸形 

分 类 号：R445[医药卫生—影像医学与核医学]