摘要
目的探讨孕中期血清甲胎蛋白(AFP)、游离-β亚基-促绒毛膜性腺激素(free-β-HCG)在胎儿开放性神经管缺陷(ONTD)诊断中的作用。方法选取2019年7月至2022年7月苏州市中西医结合医院(木渎人民医院)收治的150例疑似胎儿ONTD的孕妇,以引产或分娩结果为金标准,分析孕妇血清AFP、free-β-HCG检测结果。根据金标准分为发生组(n=33)和未发生组(n=117),分析血清AFP、free-β-HCG水平及二者联合检测ONTD的诊断效能。分析血清AFP、free-β-HCG水平单独及二者联合检测对不同类型ONTD的诊断符合率。结果通过引产或分娩结果显示,共有33例ONTD胎儿;经血清AFP水平检查显示,共有26例ONTD胎儿;经血清free-β-HCG水平检查显示,共有27例ONTD胎儿;血清AFP、free-β-HCG水平联合检查显示,共有32例ONTD胎儿。与血清AFP、free-β-HCG单独检查比较,联合检查有较高的灵敏度90.91%和准确率96.67%,较低的漏诊率9.10%。与血清AFP、free-β-HCG单独检查相比,联合检查对于脊柱裂胎儿检出率较高(P<0.05)。结论联合检测孕中期血清AFP、free-β-HCG水平可提高ONTD诊断的准确率,可为孕中期胎儿ONTD的筛查提供一种新的有效手段。
Objective To investigate the role of serum alpha⁃fetoprotein(AFP)and free⁃β⁃human chorionic gonadotropin(free⁃β⁃HCG)in fetal open neural tube defects(ONTD).Methods A total of 150 pregnant women with suspected fetal ONTD admitted to Suzhou Hospital of Integrated Traditional Chinese and Western Medicine(Mudu Peoples Hospital)from July 2019 to July 2022 were selected.The results of serum AFP and free⁃β⁃HCG in pregnant women were analyzed using induced labor or delivery as the gold standard.Based on the gold standard,they were divided into the occurrence group(n=33)and the non⁃occurrence group(n=117).The diagnostic efficacy of serum AFP,free⁃β⁃HCG levels,and their combined detection for ONTD were analyzed.The diagnostic coincidence rates of serum AFP,free⁃β⁃HCG levels alone and their combined de⁃tection for different types of ONTD were also analyzed.Results The results of induced labor or delivery showed that there were 33 ONTD fetuses.A total of 26 ONTD fetuses were detected by serum AFP levels,while 27 were detected by serum free⁃β⁃HCG levels.In 32 cases of ONTD fetuses a combined detection of se⁃rum AFP and free⁃β⁃HCG levels were conducted.Compared to using serum AFP and free⁃β⁃HCG levels alone,the combined examination showed a higher sensitivity of 90.91%and accuracy of 96.67%,with a lower missed diagnosis rate of 9.10%.Additionally,the combined examination had a higher detection rate for spina bifida fe⁃tuses compared to using serum AFP and free⁃β⁃HCG levels alone,and this difference was statistically significant(P<0.05).Conclusion The combined detection of serum AFP and free⁃β⁃HCG levels in the second tri⁃mester can enhance the accuracy of ONTD diagnosis and offer a new and effective method for screening fetal ONTD in the second trimester.
作者
戴秀丽
吴英
DAI Xiuli;WU Ying(Ultrasound Department,Suzhou Hospital of Integrated Traditional Chinese and Western Medicine(Mudu Peo-ples Hospital),Suzhou,Jiangsu,China,215101)
出处
《分子诊断与治疗杂志》
2024年第4期696-699,共4页
Journal of Molecular Diagnostics and Therapy
基金
苏州市科技发展计划(民生科技-医疗卫生应用基础研究[第二批])项目(SYSD2018047)。
