摘要
【目的】探讨孕产妇血清胎儿血红蛋白(HbF)、甲胎蛋白(AFP)联合胎儿生物物理评分(BPS)、阿氏评分(Apgar评分)诊断胎儿母体输血综合征(FMH)的价值。【方法】在本院门诊产检的100例疑似FMH的孕产妇作为研究对象,分娩后检测孕产妇血清HbF、AFP水平,并根据检查结果将孕产妇分为FMH组(13例)和非FMH组(87例)。比较两组孕产妇HbF、AFP水平及BPS、Apgar评分,通过受试者工作特征(ROC)曲线分析HbF、AFP及BPS、Apgar评分预测FMH的价值;多因素分析采取非条件Logistic逐步回归分析。【结果】FMH组患者HbF、AFP水平显著高于非FMH组,BPS、Apgar评分显著低于非FMH组(均P<0.05);经ROC曲线分析显示,HbF、AFP及BPS、Apgar评分可用于发生FMH的预测,曲线下面积分别为0.897、0.810、0.829、0.941,联合诊断曲线下面积为0.980;经多因素Logistic回归分析证实,HbF≤3.712%、AFP≤588.359 ng/mL、BPS≥5.865分、Apgar评分≥5.968分是发生FMH的危险因素。【结论】血清HbF、AFP联合BPS、Apgar评分可用于FMH的早期诊断,且联合检测具有更好的评估效能。
【Objective】To explore the value of serum fetal hemoglobin(HbF),alpha fetoprotein(AFP),combined with fetal biophysical score(BPS)and Apgar score in the diagnosis of fetal maternal transfusion syndrome(FMH)in pregnant and postpartum women.【Methods】A total of 100 pregnant and postpartum women suspected of FMH were selected as the study subjects in our outpatient department.After delivery,the serum HbF and AFP levels of pregnant and postpartum women were measured,and they were divided into FMH group(13 cases)and non FMH group(87 cases)based on the test results;We compared the HbF,AFP levels,BPS,and Apgar scores between two groups of pregnant women.The value of HbF,AFP,BPS,and Apgar scores in predicting FMH was analyzed using Receiver Operating Characteristic(ROC)curves;The multiple factor analysis adopted unconditional logistic stepwise regression analysis.【Results】The levels of HbF and AFP in the FMH group were significantly higher than those in the non FMH group,and the BPS and Apgar scores were significantly lower than those in the non FMH group(all P<0.05);According to ROC analysis,HbF,AFP,BPS,and Apgar scores can be used to predict the occurrence of FMH.The area under the curve was 0.897,0.810,0.829,and 0.941,respectively,and the area under the joint diagnostic curve was 0.980;Multiple logistic regression analysis confirmed that HbF≤3.712%,AFP≤588.359 ng/mL,BPS≥5.865 scores,and Apgar score≥5.96 scores were risk factors for the occurrence of FMH.【Conclusion】The combination of serum HbF,AFP,BPS,and Apgar score can be used for early diagnosis of FMH,and the combined detection has better evaluation efficacy.
作者
胡谢应
马雅莉
蒋晴晴
罗会涛
仲伟国
吴磊
HU Xieying;MA Yali;JIANG Qingqing(Department of Laboratory Medicine,Changning District Maternal and Child Health Hospital,Shanghai 200050)
出处
《医学临床研究》
CAS
2024年第2期207-209,213,共4页
Journal of Clinical Research
