产前超声定量参数联合血清β-人绒毛膜促性腺激素、甲胎蛋白、游离雌三醇对胎儿颜面部畸形筛查具有较好价值  

Prenatal ultrasound quantification combined with serumβ-human chorionic gonadotropin,alpha fetoprotein and uncojugated estriol has high screening value for fetal facial deformities

作　　者：郭巧玲[1] 刘海龙[1] 陈瑛[1] 石秀英[2] GUO Qiaoling;LIU Hailong;CHEN Ying;SHI Xiuying(Department of Ultrasound,Yulin City First Hospital,Yulin 719000,China;Department of Ultrasound,Yan'an University Affiliated Hospital,Yan'an 716000,China)

机构地区：[1]榆林市第一医院超声科,陕西榆林719000 [2]延安大学附属医院超声医学科,陕西延安716000

出　　处：《分子影像学杂志》2024年第12期1387-1392,共6页Journal of Molecular Imaging

基　　金：陕西省榆林市科学技术研究与开发补助资金项目([2019]185号-33)。

摘　　要：目的探讨产前超声定量联合血清β-人绒毛膜促性腺激素(β-HCG)、甲胎蛋白(AFP)、游离雌三醇(uE3)对胎儿颜面部畸形的筛查价值。方法选取2021年2月~2024年2月在我院进行产前筛查的123例孕中期孕妇为研究对象,均接受超声检查与血清指标检测,以引产或妊娠结果为“金标准”,分析产前超声定量参数、血清指标对胎儿颜面部畸形的诊断价值。结果123例孕妇最终发现胎儿颜面部畸形71例(57.72%),52例胎儿未出现颜面部畸形(42.28%)。单因素及多因素Logistic回归分析结果显示颈项透明层厚度(NT)、β-HCG、AFP及uE3水平均是胎儿颜面部畸形的危险因素(P<0.05)。超声NT诊出胎儿颜面部畸形61例,血清指标诊出胎儿颜面部畸形56例,联合检测诊出胎儿颜面部畸形67例,超声NT联合血清指标检测对胎儿颜面部畸形的诊断敏感度、特异度及准确度均高于单一检测,组间敏感度差异有统计学意义(P<0.05),但两组特异度、准确度的差异无统计学意义(P>0.05)。结论NT、β-HCG、AFP及uE3水平异常均提示胎儿颜面部畸形发生的高风险性。产期超声定量参数联合血清β-hCG、AFP、uE3可明显提高对胎儿颜面部畸形的检出敏感度,对产前颜面部畸形筛查有着较好的临床应用价值。Objective To investigate the value of prenatal ultrasound quantification combined with serumβ-human chorionic gonadotropin(β-HCG),alpha fetoprotein(AFP)and uncojugated estriol(uE3)in screening fetal facial deformities.Methods A total of 123 pregnant women in the second trimester of pregnancy who received prenatal screening at the hospital from February 2021 to February 2024 were selected as the research subjects.All of them underwent ultrasound examination and detection of serum indexes.The outcomes of induced labor or pregnancy were used as the gold standard to analyze the diagnostic value of prenatal ultrasound quantitative parameters and serum indexes for fetal facial deformities.Results Among 123 pregnant women,71(57.72%)were found to have fetal facial deformities,and 52(42.28%)did not have any fetal facial deformities.They were included in the deformity group and the non-deformity group,respectively.Univariate analysis and multivariate logistic regression analysis results showed that fetal nuchal translucency(NT)thickness,and the levels ofβ-HCG,AFP and uE3 were risk factors for fetal facial deformities(P<0.05).61 cases and 56 cases of fetal facial deformities were diagnosed by NT and serum indexes,respectively.Combination of the two diagnosed 67 cases of fetal facial deformities.The diagnostic sensitivity,specificity,and accuracy of NT combined with serum indexes were higher than those of separate diagnosis.There was a statistically significant difference in sensitivity(P<0.05),but there was no statistically significant difference in specificity or accuracy(P>0.05).Conclusion Abnormal NT,and abnormal levels ofβ-HCG,AFP and uE3 all indicate a high risk of fetal facial deformities.The combination of prenatal ultrasound quantitative parameters and serumβ-HCG,AFP and uE3 can significantly improve the sensitivity in detecting fetal facial deformities.It has relatively high clinical value in fetal facial deformities screening.

关 键 词：产前超声 Β-人绒毛膜促性腺激素 甲胎蛋白 游离雌三醇 颜面部畸形 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]