摘要
目的探究超声胎儿颈部透明层厚度(NT)值、血清妊娠相关蛋白-A(PAPP-A)、胎盘生长因子(PLGF)水平与孕中期胎儿染色体异常相关性分析及对妊娠结局的影响。方法选取我院2017年1月~2019年6月孕中期胎儿染色体异常孕妇120例作为研究组,另选同期孕中期胎儿染色体正常孕妇120例作为对照组。均行超声NT检查、血清PAPP-A、PLGF水平检测。比较两组超声NT值、血清PAPP-A、PLGF水平,应用Logistic回归分析探究孕中期胎儿染色体异常发生影响因素,应用Pearson分析超声NT值、血清PAPP-A、PLGF水平与孕中期胎儿染色体异常相关性,统计对比研究组不同妊娠结局者孕中期超声NT值、血清PAPP-A、PLGF水平,应用受试者工作特征曲线(ROC)评价孕中期超声NT值、血清PAPP-A、PLGF水平对不良妊娠结局的预测价值。结果研究组超声NT值高于对照组,血清PAPP-A、PLGF水平低于对照组(P<0.05);Logistic回归分析显示,超声NT值、血清PAPP-A、PLGF水平是孕中期胎儿染色体异常发生的重要影响因素(P<0.05);经Pearson分析可知,超声NT值(r=0.724)与孕中期胎儿染色体异常呈正相关,血清PAPP-A(r=-0.416)、PLGF(r=-0.622)水平与孕中期胎儿染色体异常呈负相关(P<0.05);研究组不良妊娠结局者孕中期超声NT值高于良好妊娠结局者,血清PAPP-A、PLGF水平低于良好妊娠结局者(P<0.05);ROC曲线分析显示,孕中期超声NT值AUC为0.763,大于血清PAPP-A(0.632)、PLGF(0.637),当截断值>3.98时,敏感度为75.00%,特异度为75.00%。结论超声NT值与孕中期胎儿染色体异常呈正相关,血清PAPP-A、PLGF水平与之呈负相关,且属于孕中期胎儿染色体异常发生的重要影响因素,在预测不良妊娠结局方面具有可靠临床价值。
Objective:To investigate the correlation between the thickness of the transparent layer of the fetal neck(NT),serum pregnancy associated protein-A(PAPP-A),placental growth factor(PLGF)and fetal chromosomal abnormalities in the second trimester and the pregnancy outcome.influences.Methods:A total of 120 pregnant women with fetal chromosomal abnormalities in the second trimester of pregnancy from January 2017 to June 2019 were enrolled as the study group.120 pregnant women with normal fetal chromosomes were selected as the control group.Ultrasound NT examination,serum PAPP-A,and PLGF levels were detected.Ultrasound NT values,serum PAPP-A and PLGF levels were compared between the two groups.Logistic regression analysis was used to investigate the influencing factors of fetal chromosomal abnormalities in the second trimester.Pearson analysis of ultrasound NT values,serum PAPP-A and PLGF levels were associated with fetal chromosomal abnormalities in the second trimester.Sexual,statistical comparison study group of different pregnancy outcomes in the second trimester of ultrasound NT values,serum PAPP-A,PLGF levels,using the receiver operating characteristic curve(ROC)to evaluate the mid-pregnancy ultrasound NT value,serum PAPP-A,PLGF levels are not good Predictive value of pregnancy outcomes.Results:The ultrasound NT value of the study group was higher than that of the control group.The serum levels of PAPP-A and PLGF were lower than those of the control group(P<0.05).Logistic regression analysis showed that the ultrasound NT value,serum PAPP-A and PLGF levels were fetal chromosomal abnormalities in the second trimester.The important influencing factors(P<0.05);Pearson analysis showed that the ultrasound NT value(r=0.724)was positively correlated with fetal chromosomal abnormalities in the second trimester,serum PAPP-A(r=-0.416),PLGF(r=-0.622).The level was negatively correlated with fetal chromosomal abnormalities in the second trimester(P<0.05).In the study group,the adverse NT outcomes were higher than the good pregnancy outcomes,and the serum PAPP-A and PLGF levels were lower than those of the good pregnancy outcomes.(P<0.05);ROC curve analysis showed that the ultrasound NT value AUC was 0.763 in the second trimester,which was greater than serum PAPP-A(0.632)and PLGF(0.637).When the cutoff value was>3.98,the sensitivity was 75.00%and the specificity was 75.00%..Conclusion:Ultrasound NT value is positively correlated with fetal chromosomal abnormality in the second trimester.Serum PAPP-A and PLGF levels are negatively correlated with it,and it is an important influencing factor of fetal chromosomal abnormalities in the second trimester.It has reliable clinical value in predicting adverse pregnancy outcomes.
作者
吕向坤
魏杏茹
庞旭姣
LV Xiang-kun;WEI Xing-ru;PANG Xu-jiao(The eighty Second Army Hospital of the People′s Liberation Army,Baoding,Hebei 071000,China;Maternal and Child Health Hospital in Baoding,Hebei,071000,China;The Seventh People′s Hospital of Hebei Province,Hebei Dingzhou,073000,China)
出处
《中国优生与遗传杂志》
2020年第4期455-458,共4页
Chinese Journal of Birth Health & Heredity
