孕早期胎儿超声指标在21-三体综合征中的诊断价值

Diagnostic value of ultrasonography of fetuses with trisomy 21 syndrome in early pregnancy

目的探讨颈项透明层厚度、额-上颌角及鼻前软组织厚度与鼻骨长度比值在孕早期21-三体综合征中的诊断价值。方法将2016年1月至2016年12月于本院行产前诊断并经染色体分析确诊为21-三体综合征的42例胎儿纳入病例组,选取同期行产前诊断并经超声检查确诊为正常的80例胎儿纳入对照组。对比分析两组胎儿颈项透明层厚度、额-上颌角及鼻前软组织厚度与鼻骨长度比值。结果病例组胎儿颈项透明层厚度显著大于对照组(P<0.05),颈项透明层增厚者比例显著高于对照组(P<0.05),额-上颌角显著大于对照组(P<0.05),额-上颌角增大者比例显著高于对照组(P<0.05),鼻前软组织厚度与鼻骨长度比值显著大于对照组(P<0.05),鼻前软组织厚度与鼻骨长度比值增大者比例显著高于对照组(P<0.05)。联合检测颈项透明层厚度、额-上颌角及鼻前软组织厚度与鼻骨长度比值对21-三体综合征诊断的灵敏度和约登指数均高于单独检测颈项透明层厚度及联合检测颈项透明层厚度和额-上颌角。结论孕早期21-三体综合征胎儿颈项透明层厚度、额-上颌角及鼻前软组织厚度与鼻骨长度比值均显著大于正常胎儿,联合检测此三项指标可提高21-三体综合征诊断的灵敏度和约登指数。

Objective To investigate the diagnostic value of nuchal translucency thickness,frontomaxillary facial angle and the prenasal thickness to nasal bone length ratio in fetuses with trisomy21syndrome.Method From January2016to December2016,42cases of trisomy21syndrome diagnosed by prenatal diagnosis in our hospital were selected as case group,and the other80normal fetuses were selected as control group.The nuchal translucency thickness,frontomaxillary facial angle and prenasal thickness to nasal bone length ratio of the two groups were compared.Result The nuchal translucency thickness in case group was significantly higher than that in control group(P<0.05),and the proportion of nuchal translucency thickening wassignificantly greater than that in control group(P<0.05).The frontomaxillary facial angle in case group was significantly greater than that in control group(P<0.05),and the proportion of the frontomaxillary facial angle enlargement was significantly higher than that of control group(P<0.05).The prenasal thickness to nasal bone length ratio in case group was significantly larger than that in control group(P<0.05),and the prenasal thickness to nasal bone length ratio enlargement was significantly higher than that in control group(P<0.05).The sensitivity and Youden index of the combined application of nuchal translucency thickness,nuchal translucency thickness and the prenasal thickness to nasal bone length ratio for trisomy21syndrome diagnostic were higher than the nuchal translucency thickness alone and the combination of nuchal translucency thickness and nuchal translucency thickness.Conclusion The nuchal translucency thickness,frontomaxillary facial angle and the prenasal thickness to nasal bone length ratio of fetuses with trisomy21syndrome are significantly greater than those of normal fetuses,the combination of the three indexes can improve the sensitivity and Youden index of diagnosis for trisomy21syndrome in early pregnancy.