摘要
目的探讨超声软指标联合血清β-人绒毛膜促性腺激素(β-hCG)、游离雌三醇(uE3)、甲胎蛋白(AFP)检测在孕中期唐氏综合征(DS)产前筛查中的应用价值。方法选取2007年1月至2020年3月于我院行产前检查疑似高危染色体异常孕妇246例,均于孕中期(孕15~20+6w)接受染色体检查、血清学检测及超声软指标检查,根据染色体检查结果分为DS组(159例)与非DS组(87例)。比较两组血清β-hCG、uE3、AFP水平;统计两组超声软指标筛查结果;采用受试者工作特征(ROC)曲线分析超声软指标和血清β-hCG、uE3、AFP对DS的诊断价值。结果DS组血清β-hCG水平高于非DS组,血清uE3、AFP水平均低于非DS组,差异有统计学意义(P<0.05)。DS组各项超声软指标异常检出率均高于非DS组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示:超声软指标诊断DS的曲线下面积(AUC)、敏感度、特异度分别为0.669、72.95%、60.92%;血清β-hCG、uE3、AFP诊断DS的AUC分别为0.703、0.696、0.766,敏感度分别为69.81%、77.99%、76.10%;特异度分别为66.67%、60.92%、67.82%;超声软指标联合血清三项诊断DS的AUC、敏感度、特异度分别为0.911、89.94%、79.31%,均明显高于单项检测(P<0.05)。结论超声软指标和血清β-hCG、uE3、AFP对孕中期DS产前筛查均有一定诊断价值,且联合检测的诊断效能显著高于单项检测,可提高DS产前筛查的准确性。
Objective:To explore the application value of ultrasound soft index combined with serumβ-hCG,uE3 and AFP in prenatal screening of Down′s syndrome(DS).Methods:246 pregnant women with suspected high-risk chromosomal abnormalities were selected from January 2007 to March 2020 in our hospital.All patients underwent chromosome examination,serological detection and ultrasonic soft index examination at 15~20+6 weeks of gestation.According to the results of chromosome examination,they were divided into DS group(159 cases)and non DS group(87 cases).The serum levels ofβ-hCG,uE3 and AFP were compared between the two groups.Statistical analysis of two groups of ultrasound soft index screening results.ROC curve was used to analyze the value of ultrasound soft index and serumβ-hCG,uE3 and AFP in diagnosis of DS.Results:Serumβ-hCG level in DS group was higher than that of non DS group,serum uE3 and AFP levels were lower than those of non DS group(P<0.05).The abnormal detection rate of ultrasound soft indexes in DS group was higher than that of non DS group(P<0.05).The results of ROC curve analysis showed that:The AUC,sensitivity and specificity of ultrasound soft index in diagnosis of DS were 0.669,72.95%and 60.92%,respectively.The AUC,sensitivity and specificity of serumβ-hCG in diagnosis of DS were 0.703,69.81%and 66.67%,respectively;The AUC,sensitivity and specificity of serum uE3 were 0.696,77.99%and 60.92%respectively;The AUC,sensitivity and specificity of serum AFP in diagnosis of DS were 0.766,76.10%and 67.82%,respectively;The AUC,sensitivity and specificity of ultrasound soft markers combined with serological detection were 0.911,89.94%and 79.31%,respectively,which were significantly higher than those of single detection(P<0.05).Conclusion:Ultrasound soft index and serumβ-hCG,uE3,AFP have certain diagnostic value in prenatal screening of DS,and the diagnostic efficiency of combined detection is significantly higher than that of single detection,which can improve the accuracy in prenatal screening of DS.
作者
唐君
何斌
韩代文
罗蔚
庞令
TANG Jun;HE Bin;HAN Dai-wen;LUO Wei;PANG Ling(Department of Eugenics/Prenatal Diagnosis Center,West China Second Hospital of Sichuan University,Chengdu 610000,China)
出处
《中国优生与遗传杂志》
2020年第7期826-829,885,共5页
Chinese Journal of Birth Health & Heredity
