超声胎儿颈项透明层指标与母体血清学筛查在胎儿21-三体综合征产前诊断中的价值

The value of ultrasound fetal nuchal translucency index and maternal serological screening in prenatal diagnosis of fetal trisomy 21 syndrome

目的探讨胎儿21-三体综合征产前诊断中超声胎儿颈项透明层(NT)指标与母体血清学筛查的应用价值。方法选取2015年2月至2020年2月于本院就诊的266例孕早期孕妇作为研究对象,均行超声NT检测及游离雌三醇、游离人绒毛膜促性腺激素β、甲胎蛋白检测,分析超声NT指标、母体血清学筛查单独诊断与联合诊断胎儿21-三体综合征的应用价值。结果21-三体综合征孕妇NT厚度厚于非21-三体综合征孕妇,游离人绒毛膜促性腺激素β水平高于非21-三体综合征孕妇,游离雌三醇、血清甲胎蛋白水平均低于非21-三体综合征孕妇,差异有统计学意义(P<0.05)。母体血清学诊断胎儿21-三体综合征的准确度、灵敏度与特异度分别为90.23%、74.07%、94.34%;超声NT诊断胎儿21-三体综合征的准确度、灵敏度与特异度分别为94.74%、81.48%、98.11%;母体血清学联合超声NT诊断胎儿21-三体综合征的准确度、灵敏度与特异度分别为99.25%、96.30%、100.00%;母体血清学联合超声NT诊断胎儿21-三体综合征的准确度、灵敏度与特异度均高于单独母体血清学、单独超声NT诊断,差异有统计学意义(P<0.05)。结论胎儿21-三体综合征产前诊断中超声NT指标联合母体血清学筛查的应用价值显著。

Objective To explore the application value of ultrasound fetal nuchal translucency(NT)index and maternal serological screening in prenatal diagnosis of fetal trisomy 21 syndrome.Methods 266 pregnant women admitted to our hospital from February 2015 to February 2020 were selected as the study subjects.All of them underwent ultrasonic NT detection and detection of free estriol,free human chorionic gonadotropinβand alpha-fetoprotein.The application value of ultrasonic NT index and maternal serological screening in the single diagnosis and combined diagnosis of fetal trisomy 21 syndrome was analyzed.Results The NT thickness in pregnant women with trisomy 21 syndrome was thicker than that in pregnant women with non trisomy 21 syndrome,and free human chorionic gonadotropin in pregnant women with trisomy 21 syndromeβwere higher than pregnant women with non trisomy 21 syndrome,while the levels of free estriol and serum alpha fetoprotein were lower in pregnant women with non trisomy 21 syndrome,the difference was statistically significant(P<0.05).The accuracy,sensitivity,and specificity of maternal serological diagnosis of fetal trisomy 21 syndrome were 90.23%,74.07%,and 94.34%,respectively.The accuracy,sensitivity,and specificity of ultrasound NT in diagnosing fetal trisomy 21 syndrome were 94.74%,81.48%,and 98.11%,respectively.The accuracy,sensitivity,and specificity of maternal serology combined with ultrasound NT in diagnosing fetal trisomy 21 syndrome were 99.25%,96.30%,and 100.00%,respectively,the accuracy,sensitivity,and specificity of maternal serological screening combined with ultrasound NT in diagnosing fetal trisomy 21 syndrome were higher than those of Maternal serological screening and ultrasound NT alone,the differences were statistically significant(P<0.05).Conclusion The application value of ultrasound NT indicators combined with maternal serological screening in prenatal diagnosis of fetal trisomy 21 syndrome is significant.