超声心动图联合孕妇血清DLL4和VEGF水平检测对胎儿先天性心脏病的早期诊断价值

Early Diagnostic Value of Echocardiography Combined with Maternal Serum DLL4 and VEGF Levels for Fetal Congenital Heart Disease

目的 探讨超声心动图检查联合孕妇血清Delta样配体4(DLL4)、血管内皮生长因子(VEGF)水平检测对胎儿先天性心脏病的临床诊断价值。方法 选择2020年5月至2022年1月期间于本院行产检的172例孕妇为研究对象,根据手术病理结果是否为无先天性心脏病将孕妇分为正常组120例和异常组52例。采用酶联免疫吸附法检测孕妇血清DLL4和VEGF水平,采用彩色多普勒超声诊断仪对所有孕妇进行检查;绘制受试者操作特征(ROC)曲线检验孕妇血清DLL4和VEGF水平对胎儿先天性心脏病的早期诊断价值;采用Kappa检验分析一致性。结果 超声心动图检查结果与金标准诊断结果一致性较高,Kappa值为0.630(P <0.05)。异常组孕妇血清DLL4和VEGF水平显著高于正常组,差异有统计学意义(P <0.05)。孕妇血清DLL4和VEGF诊断胎儿先天性心脏病的曲线下面积(AUC)分别为0.734、0.743。孕妇血清DLL4检查结果与金标准诊断结果一致性中度,Kappa值为0.464(P <0.05);孕妇血清VEGF检查结果与金标准诊断结果一致性较差,Kappa值为0.303(P <0.05)。超声心动图联合孕妇血清DLL4和VEGF水平检查与金标准诊断结果一致性极高,Kappa值为0.803(P<0.05)。超声心动图联合孕妇血清DLL4和VEGF水平检测诊断胎儿先天性心脏病的灵敏度、准确度明显高于三者单独诊断(P <0.05)。结论 超声心动图联合孕妇血清DLL4和VEGF水平检测可有效提高诊断胎儿先天性心脏病的灵敏度、准确度。

Objective To investigate the clinical diagnostic value of echocardiography combined with maternal serum Delta like ligand 4(DLL4) and vascular endothelial growth factor(VEGF) levels for fetal congenital heart disease.Methods A total of 172 pregnant women who underwent antenatal examination in our hospital from May 2020 to January 2022 were selected as the study subjects,the pregnant women were divided into normal group(120 cases) and abnormal group(52 cases) according to whether the surgical and pathological results were free of congenital heart disease.The levels of serum DLL4 and VEGF of pregnant women were detected by ELISA,all pregnant women were examined with color Doppler ultrasound diagnostic instrument;the receiver operating characteristic(ROC) curve was drawn to test the early diagnostic value of maternal serum DLL4 and VEGF levels for fetal congenital heart disease;Kappa test was used to analyze the consistency.Results The results of echocardiography were consistent with those of gold standard diagnosis,and Kappa value was 0.630(P <0.05).The levels of serum DLL4 and VEGF in abnormal group were obviously higher than those in normal group(P <0.05).The area under the curve(AUC) of maternal serum DLL4 and VEGF in diagnosing fetal congenital heart disease was 0.734 and 0.743,respectively.The results of serum DLL4 of pregnant women were moderately consistent with those of gold standard diagnosis,and Kappa value was 0.464(P<0.05);the results of serum VEGF of pregnant women were not consistent with those of gold standard diagnosis,and Kappa value was 0.303(P<0.05).The results of echocardiography combined with maternal serum DLL4 and VEGF levels were highly consistent with the gold standard diagnosis,with Kappa value of 0.803(P<0.05).The sensitivity and accuracy of echocardiography combined with maternal serum DLL4 and VEGF levels in diagnosing fetal congenital heart disease were obviously higher than those of the three alone(P <0.05).Conclusion Echocardiography combined with maternal serum DLL4 and VEGF levels can effectively improve the sensitivity and accuracy of diagnosing fetal congenital heart disease.