胎儿颈项透明层厚度在产前诊断中的价值

Value of Nuchal Translucency in Prenatal Diagnosis

目的探讨彩超检测胎儿颈项透明层（nuchal translucency,NT）厚度与胎儿染色体异常、结构异常及妊娠结局的关系并分析其在产前诊断中的价值。方法应用彩色多普勒超声诊断仪对孕11-13＋6周的3 248例孕妇行经腹超声检查,测量胎儿NT值,记录孕妇不良妊娠结局,并随访至胎儿出生后6个月。结果不同年龄孕妇的胎儿NT值（F=0.089,P=0.976）及NT增厚率（X^2=0.432,P=0.934）比较,差异均无统计学意义;不同NT值组染色体异常检出率（X^2=559.89,P〈0.001）及不良妊娠结局发生率（X^2=494.27,P〈0.001）比较,差异有统计学意义。NT增厚组染色体异常检出率（X^2=323.28,P〈0.001）及不良妊娠结局发生率（X^2=270.66,P〈0.001）明显高于胎儿NT正常组。NT≥3.5mm组染色体异常检出率（X^2=6.46,P=0.011）及不良妊娠结局发生率（X^2=9.99,P=0.002）明显高于2.5-3.5mm组。结论 NT增厚在产前诊断中具有重要筛查意义,随着NT增厚,胎儿的染色体异常率及不良妊娠结局发生率均增高。

Objective To investigate the value of nuchal translucency（NT）in the prenatal diagnosis by analyzing the relationship of the fetal chromosome abnormality and pregnant outcomes with the fetal NT.Methods Color Doppler Ultrasound was used to measure the fetal NT of the 3 248 pregnant women in 11-13＋6 weeks with crown-rump length（CRL）between 45 mm and 84 mm and followed them up to 6 months after delivery.Results There was no statistically significant difference in terms of fetal NT among different age groups（F=0.089,P=0.976）.There was statistically difference in terms of fetal chromosome abnormality and adverse pregnancy outcome among different NT group（X^2=559.89,P〈0.001andX^2=494.27,P〈0.001）.The fetal chromosome abnormality and adverse pregnancy outcome with increased NT were obviously higher than those with normal NT（X^2=323.28,P〈0.001andX^2=270.66,P〈0.001）.The fetal chromosome abnormality and adverse pregnancy outcome in fetal NT ≥3.5mm group were obviously higher than those fetal3.5mm group（X^2=6.46,P=0.011and2=9.99,P=0.002）.Conclusion The increased NT has significant value in prenatal diagnosis.Fetal chromosome abnormality and adverse pregnancy outcome rises with fetal NT increases.