联合检测母血HbF、AFP值在预测胎母输血综合征中的应用价值

Application Value of Joint Detection in Maternal Blood HbF and AFP to Predict Fetomaternal Transfusion Syndrome

目的:探讨联合检测母血胎儿有核红细胞(Hb F)、甲胎蛋白(AFP)值在预测胎母输血综合征中的应用价值。方法:选取2015年5月-2016年11月间本院门诊产检的孕产妇178例,采用KB法检测母血Hb F水平,ELISA法检测母血AFP水平,依据分娩后检查结果为标准将所有孕产妇分为综合征组和非综合征组,统计分析所有孕产妇母血Hb F、AFP水平及不同方法预测胎母输血综合征发生的情况。结果:本研究分娩结果显示,23例(12.92%)发生胎母输血综合征,综合征组母血Hb F、AFP水平明显高于非综合征组,两组比较差异有统计学(P<0.05)。ROC曲线分析结果显示,单独检测母血Hb F并以>3%为界限预测胎母输血综合征的敏感度、特异度、准确度分别为73.91%、89.68%、87.64%,单独检测母血AFP并以>1000 ng/m L为界限,敏感度、特异度、准确度分别为73.91%、90.97%、88.76%,两者联合检测时,敏感度、特异度、准确度分别为100%、96.77%、97.19%,两者联合检测高于两者单独检测,差异有统计学差异(P<0.05)。结论:胎母输血综合征的发生与孕产妇产前母血Hb F、AFP水平有关,检测上述因子水平在预测胎母输血综合征中具有良好的敏感性、特异性和准确性,且两者联合检测具有更好的预测效能,有利于指导防治该病。

Objective：To discuss the application value of joint detection in maternal blood Hb F and AFP to predict fetomaternal transfusion syndrome.Method：From May 2015 to November 2016,178 maternal woman at our outpatient were selected,KB test was used to test the Hb F level of maternal blood,ELISA was used to detect the AFP level of maternal blood,all maternal woman were divided into syndrome group and non-syndrome group according to the inspection result of after delivery,the efficiency of two methods to predict fetomaternal transfusion syndrome were analyzed.Result：After delivery,23 cases（12.92%）were diagnosed as fetomaternal transfusion syndrome,the blood Hb F and AFP level of syndrome group were higher than that of non-syndrome group,the differences were statistic significant（P〈0.05）.ROC curve analysis results showed that the sensitivity,specificity and accuracy of solely detected the maternal blood Hb F（limited by if 〉3%）to predicted fetomaternal transfusion syndrome were 73.91%,89.68%,87.64%,the sensitivity,specificity and accuracy of solely detected the maternal blood AFP（limited by if 〉1000 ng/m L） were 73.91%,90.97% and 88.76%,the sensitivity,specificity and accuracy of joint detection were 100%,96.77% and 97.19%,which were higher than that of single detected,the differences were statistically significant（P〈0.05）.Conclusion：The Hb F and AFP level of maternal blood is associated with fetomaternal transfusion syndrome,both of which predict fetal blood transfusion syndrome has good sensitivity,specificity and accuracy,but the joint detection has better prediction performance and is helpful to guide the prevention and control of the fetomaternal transfusion syndrome.