孕中期母血清三联标记物预测Hb Bart's水肿胎初探

Forecasting Hb Bart's hydrops fetalis by Second-trimester maternal serum triple markers

目的:探讨孕中期母血清三联标记物对Hb Bart's水肿胎的预测价值。方法:采用全自动时间荧光分辨法检测孕中期母血清甲胎蛋白(AFP)、游离β-人绒毛膜促性腺激素(freeβ-HCG)和非结合雌三醇(μE3)水平,母血清三联标记物水平以中位数倍数(MoM)表示。比较23例Hb Bart's水肿胎和230例正常孕妇的孕中期母血清三联标记物水平,并采用ROC曲线分析其对Hb Bart's水肿胎的预测价值。结果:Hb Bart's水肿胎组母血清freeβ-HCG明显高于对照组(2.51 MoM vs 1.02 MoM,P<0.05),两组AFP和μE3无统计学差异(P>0.05)。freeβ-HCG预测Hb Bart's水肿胎的曲线下面积为95.0%,以1.32 MoM为切割值,敏感度和特异度分别为95.7%和89.6%。结论:孕中期母血清freeβ-HCG对Hb Bart's水肿胎具有较高的预测价值。

Objective：To measure the value of second-trimester maternal serum triple markers as predictors of Hb Bart＇s hydrops fetalis.Methods：The levels of maternal serum AFP,free β-HCG and μE3 were measured by auto time-resolved fluoroimmunoassay system,which were expressed as multiple of the median（MoM）.The levels of second-trimester maternal serum triple markers were compared between 23 cases of Hb Bart＇s hydrops fetalis and 230 normal pregnant women.ROC curve were applied to evaluate the value of second-trimester maternal serum markers as predictors of Hb Bart＇s hydrops fetalis.Results：Maternal serum concentration of free β-HCG was significantly increased in women with pregnancies affected by Hb Bart＇s hydrops fetalis than that in control group（2.51 MoM vs 1.02 MoM,P0.05）.The concentrations of AFP and μE3 were not significantly different between the two groups（P0.05）.The area under the curve of free β-HCG as predictors of Hb Bart＇s hydrops fetalis was 95.0%.The best cutoff value was 1.32 MoM,the sensitivity and specificity were 95.7% and 89.6%,respectively.Conclusion：Maternal serum free β-HCG has a high predictive value of Hb Bart＇s hydrops fetalis.