胎儿超声心动图联合母体血清标志物对胎儿先天性心脏病的诊断价值

Diagnostic value of fetal echocardiography combined with maternal serum markers for fetal congenital heart disease

目的分析胎儿超声心动图联合母体血清标志物对胎儿先天性心脏病的诊断价值。方法选取2019年2月—2021年10月在金华市中心医院进行产前检查的132例孕妇作为研究对象,根据妊娠结局将确诊为胎儿先天性心脏病的82例孕妇作为研究组,另外50例胎儿未发现心脏异常的孕妇作为对照组。采用彩色多普勒超声诊断仪对胎儿进行检查,检测两组胎儿主动脉血流参数、肺动脉血流参数、母体血清标志物,ROC曲线分析胎儿超声心动图参数、母体血清标志物对胎儿先天性心脏病的诊断价值。结果与对照组相比,研究组ESRV(24.21±3.57)ml/min vs.(35.05±4.22)ml/min参数升高,PSV(110.37±21.85)ml/min vs.(100.24±18.77)ml/min、PSV/ESRV(4.22±0.53)vs.(2.37±0.31)参数降低,差异均有统计学意义(均P<0.05)。与对照组相比,研究组VRI(9.56±0.85)mm Hg vs.(14.24±2.53)mm Hg、PVmax/AVmax(0.71±0.08)vs.(1.52±0.23)参数升高,ET(215.25±32.01)ms vs.(186.25±20.34)ms、DT(172.14±28.94)ms vs.(144.20±23.04)ms、ACT(42.65±5.33)ms vs.(34.28±4.22)ms参数降低,差异均有统计学意义(均P<0.05)。与对照组相比,研究组AFP(6.25±0.73)μg/L vs.(38.22±4.17)μg/L、free-β-hCG(4.25±0.53)U/L vs.(19.25±2.36)U/L表达水平升高,差异均有统计学意义(均P<0.05)。ROC曲线显示,与主动脉血流参数、肺动脉血流参数、AFP、free-β-hCG单项诊断相比,联合检测对胎儿先天性心脏病的诊断价值较高,差异有统计学意义(P<0.05)。结论胎儿超声心动图、母体血清标志物联合检测,可提高胎儿先天性心脏病的诊断价值,可用于胎儿先天性心脏病的筛查。

Objective To analyze the diagnostic value of fetal echocardiography combined with maternal serum markers in fetal congenital heart disease.MethodsA total of 132 pregnant women who underwent prenatal examination in Jinhua Central Hospital from February 2019 to October 2021 were selected as the study objects.According to the pregnancy outcome,82 pregnant women whose fetuses were diagnosed with congenital heart disease were selected as the study group,and 50 pregnant women whose fetuses were not found to have heart abnormalities were selected as the control group.The parameters of fetal aortic blood flow,pulmonary artery blood flow were detected by color Doppler ultrasound diagnostic instrument.Maternal venous blood was collected for detection of serum markers.ROC curve was used to analyze the diagnostic value of fetal echocardiography parameters and maternal serum markers for fetal congenital heart disease.Results ESRV parameters in the study group were higher than in the control group(24.21±3.57 us.35.05±4.22)ml/min.PSV(110.37±21.85 vs.100.24±18.77)ml/min and PSV/ESRV(4.22±0.53 vs.2.37±0.31)parameters were decreased in the study group.The differences were statistically significant(P<0.05).Compared with the control group,the VRI(9.56±0.85 us.14.24±2.53)mm Hg and PVmax/AVmax(0.71±0.08 us.1.52±0.23)parameters in the study group were significantly increased.ET(215.25±32.01 vs.186.25±20.34)ms,DT(172.14±28.94 us.144.20±23.04)ms,ACT(42.65±5.33 us.34.28±4.22)ms parameters were significantly decreased(P<0.05).Compared with the control group,the expression levels of AFP(6.25±0.73 us.38.22±4.17)μg/L and free-β-hCC(4.25±0.53 us.19.25±2.36)U/L in the study group were significantly increased(P<0.05).ROC curve showed that compared with the single diagnosis of aortic blood flow parameters,pulmonary artery blood flow parameters,AFP and free-β-hCG,the combined detection had a higher diagnostic value for fetal congenital heart disease(P<0.05).Conclusion The combined detection of fetal echocardiography and maternal serum markers can improve the diagnostic value of fetal congenital heart disease,and can be used for the screening of fetal congenital heart disease.