超声检测胎儿颈项透明层厚度联合血清孕酮及促甲状腺素检测对胎儿产前诊断和妊娠结局预测的价值

Value of ultrasound detection of fetal NT combined with serum PROG and TSH detection for the prenatal diagnosis of fetus and the prediction of pregnancy outcome

目的:探讨超声检测胎儿颈项透明层厚度(NT)联合血清孕酮(PROG)及促甲状腺素(TSH)检测对胎儿产前诊断和妊娠结局预测中的价值。方法:选择医院正常产检的45例孕早期胎儿染色体异常的孕妇作为研究组,采用1∶1配对法另选取同期45例胎儿发育正常的孕妇作为对照组,于孕10周之前检测两组血清PROG及TSH水平,于11~14周检测两组NT值,研究组随访至妊娠终止,比较不同妊娠结局孕妇血清PROG、TSH水平及NT值。采用受试者工作特征(ROC)曲线评价血清PROG、TSH、NT单独及联合产前诊断和预测预后的价值。结果:研究组孕妇PROG水平明显低于对照组,且TSH水平及NT值明显高于对照组,差异有统计学意义(t=8.849,t=14.840,t=30.021;P<0.05);上述指标联合进行产前诊断的ROC曲线下面积(AUC)为0.960,明显高于单独产前诊断的AUC值,差异有统计学意义(x^(2)=1.228,P<0.05)。研究组不同妊娠结局孕妇血清PROG、TSH水平及NT值对比,差异有统计学意义(t=2.781,t=3.179,t=10.835;P<0.05)。PROG、TSH及NT值三项联合预测孕妇妊娠结局的AUC值高于各项指标单独预测,差异有统计学意义(x^(2)=1.118,P<0.05)。结论:孕早期胎儿染色体异常孕妇血清PROG水平下降,TSH及胎儿NT值升高,明确其水平可为产前诊断和预测妊娠结局提供可靠依据。

Objective:To explore the value of ultrasound detection of fetal nuchal translucency(NT)combined with serum progesterone(PROG)and thyroid stimulating hormone(TSH)in prenatal diagnosis and prognosis prediction.Methods:A total of 45 pregnant women whose fetuses’chromosomes were abnormality in the early pregnancies of them as the results of normally prenatal examination were selected in the research group,and the 1:1 matching method was used to select 45 normally pregnant women whose fetuses’developments were normal as the control group.In the first 10 weeks of pregnancy,the serum PROG and TSH levels of two groups were detected,and the NT values of two groups were detected during the 11th week and the 14th week.The follow-up of research group was until to termination of pregnancy,and the serum PROG level,TSH level and NT value of pregnant women with different pregnant outcomes were compared.The receiver operating characteristic(ROC)curve was used to evaluate the values of single serum PROG,TSH and NT,and combination of them in prenatal diagnosis and prognosis prediction.Results:The PROG level of research group was significantly lower than that of control group,and the TSH level and NT value of research group were significantly higher than those of control group(t=8.849,t=14.840,t=30.021,P<0.05),respectively.The area under curve(AUC)value of ROC curve of the combined diagnosis of the above indicators was 0.960,which was significantly higher than that of each single prenatal diagnosis,the differences of them were significant(x^(2)=1.228,P<0.05).In the research group,the differences of serum PROG level,TSH level and NT value among pregnant women with different pregnant outcomes were significant(t=2.781,t=3.179,t=10.835,P<0.05),respectively.The AUC value of combined diagnosis of PROG,TSH and NT value was significantly higher than that of each single diagnosis in predicting the pregnant outcomes of pregnant women,the differences of them were significant(x^(2)=1.118,P<0.05).Conclusion:In the pregnant women whose fetuses’chromosomes were abnormality in the early pregnancies of them,the serum PROG level decreases,while the TSH level and NT value increase.The determinations of their levels can provide reliable references for the prenatal diagnosis and the prediction of pregnant outcome.