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目的探究胎儿畸形筛查中B超测量颈项透明层(NT)值的作用。方法回顾性分析269例定期行产前检查的高危胎儿畸形的孕产妇的临床资料,均于孕11~13周采用B超行NT值检测,关于染色体、引产、分娩或尸检结果均详细记录。评估孕早期B超测量NT值对胎儿畸形诊断的准确度、敏感度和特异度。绘制受试者工作特征曲线(ROC),以曲线下面积(AUC)评估B超测量NT值在胎儿畸形筛查中的作用。结果 269例高危胎儿畸形孕产妇中共确诊20例胎儿畸形,胎儿畸形发生率为7.43%;未发现畸形的胎儿中,B超测量NT>2.5 mm者共有13例,NT≤2.5 mm者共有236例;畸形的胎儿中,B超测量NT>2.5 mm者共有15例,NT≤2.5 mm者共有5例;B超测量NT值在胎儿畸形诊断中的AUC为0.926,且不同NT值条件下对胎儿畸形筛查的灵敏度、特异度、准确度均比较高。结论胎儿畸形筛查中B超测量NT值准确性较高,值得在孕11~13周妇女中推广应用。
Objective To investigate the role of B-ultrasonography in measuring the value of NT in fetus deformity screening. Methods The clinical data of 269 pregnant women with high-risk fetal malformations undergoing prenatal examination were retrospectively analyzed. NT values of B-ultrasonography were detected at 11 to 13 weeks’ gestation. The results of chromosomes, induced abortion, childbirth or autopsy were recorded in detail. To assess the accuracy, sensitivity and specificity of B-value NT measurement during the first trimester of pregnancy for the diagnosis of fetal malformations. The receiver operating characteristic curve (ROC) was plotted and the area under the curve (AUC) was used to assess the role of B-NT in the screening of fetal malformations. Results A total of 269 fetuses with high-risk fetal malformations were diagnosed as 20 cases of fetal malformations and the incidence of fetal malformations was 7.43%. Among the fetuses without abnormalities, there were 13 cases with NT> 2.5 mm in B-mode ultrasound and 236 cases with NT≤2.5 mm ; Fetus in deformity, B-measurement of NT> 2.5 mm were 15 cases, NT ≤ 2.5 mm in a total of 5 cases; B-measurement of NT value in the diagnosis of fetal malformation AUC was 0.926, and NT values under different conditions of the fetus Deformity screening sensitivity, specificity, accuracy are higher. Conclusion B-ultrasonography is a more accurate method to measure NT value in fetal malformation screening. It is worth to be popularized in 11-11 weeks pregnant women.