摘要
目的分析早孕期胎儿颈项透明层(NT)厚度及颜面轮廓超声检查指标与21-三体综合征的相关性,探讨其对21-三体综合征的预测效力。方法选取2016年1月~2019年12月行早孕期超声检查,并经染色体检查证实为21-三体综合征的51例胎儿(观察组)进行回顾性分析,测算其NT厚度、额-上颌(FMF)角、上颌-鼻根-下颌(MNM)角、上下颌面(MMF)角和鼻前组织厚度与鼻骨长度比值(PT/NBL),并随机选取300例正常早孕期胎儿(孕期与观察组基本一致)作为对照组,比较上述超声检查指标与21-三体综合征的相关性,并应用二元Logistic回归分析探讨21-三体综合征的独立危险因素。结果两组间NT厚度、FMF角、MNM角、PT/NBL比较差异有统计学意义(均P<0.05),MMF角差异无统计学意义(P=0.317);观察组NT增厚(≥2.5 mm)、FMF角增大(>92.5°)、MNM角偏小(<6.2°)、PT/NBL增大(>0.94)及鼻骨缺失发生率均高于对照组(均P<0.05),MMF角偏小(<81.6°)发生率两组差异无统计学意义(P=0.099)。二元Logistic回归分析结果显示,鼻骨缺失(OR 9.335,P=0.004)、NT增厚(OR 8.657,P=0.000)、PT/NBL增大(OR 2.669,P=0.038)及FMF角增大(OR 2.634,P=0.049)均为早孕期21-三体综合征的独立危险因素。结论早孕期NT增厚、FMF角增大、MNM角偏小、PT/NBL增大及鼻骨缺失与21-三体综合征具有相关性,其中鼻骨缺失、NT增厚、PT/NBL增大、FMF角增大是21-三体综合征的独立危险因素。
Objective To analyze the correlations among the nuchal translucency(NT)thickness,facial profile markers and the trisomy 21 in the first-trimester screening,and to assess their predictive value for the trisomy 21.Methods Data were collected from 51 cases of fetuses with trisomy 21 and 300 cases of gestational age matched normal fetuses in first-trimester screening between Jan 2016 and Dec 2019.Factors included NT thickness and facial profile markers(frontomaxillary facial(FMF)angle,maxilla-nasion-mandible(MNM)angle,mandibulomaxillary facial(MMF)angle,the ratio of prenasal thickness(PT)to nasal bone length(NBL)(PT/NBL))in first-trimester screening.Binary logistic regression was carried out to identify the independent risk factors for the incidence of trisomy 21.Results There were statistically significant differences in NT thickness,FMF anlge,MNM angle and PT/NBL between two groups(P<0.05).Comared with the normal group,univariate analysis revealed significant differences in the trisomy 21 group among increased NT thickness,larger FMF angle,smaller MNM angle,larger PT/NBL and absent NB(P<0.05).The results of the binary logistic regression analysis indicated that absent NB(OR 9.335,P=0.004),NT thickness≥2.5 mm(OR 8.657,P=0.000),PT/NBL>0.94(OR 2.669,P=0.038)and FMF anlge>92.5°(OR 2.634,P=0.049)were the independent risk factors for the trisomy 21.Conclusion Increased NT thickness,enlarged FMF anlge,reduced MNM angle,enlarged PT/NBL and absent NB are associated trisomy 21 in first-trimester screening.Absent NB,in creased NT thickness,enlarged PT/NBL and FMF anlge are the independent risk factors for the trisomy 21.
作者
张广英
曲素慧
刘蔚
丁红宇
王莉
曹淑娟
ZHANG Guangying;QU Suhui;LIU Wei;DING Hongyu;WANG Li;CAO Shujuan(Department of Ultrasonography, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated With Shandong First Medical University, Jinan 250014, P.R.China;Department of Obstetrics and Gynecology, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated With Shandong First Medical University, Jinan 250014, P.R.China)
出处
《医学影像学杂志》
2020年第12期2188-2192,2197,共6页
Journal of Medical Imaging
基金
山东省医药卫生科技发展计划项目(编号:2016WS0474)。
关键词
超声检查
产前
早孕期
颈项透明层厚度
颜面轮廓
Ultrasonography,prental
Pregnancy trimester
Nuchal translucency thickness
Facial profile
