摘要
目的分析胎儿超声心动图联合母体血清分泌型卷曲相关蛋白5(secreted frizzled-related protein 5,SFRP5)、同型半胱氨酸(homocysteine,Hcy)浓度对先天性心脏病(先心病)胎儿的诊断效能。方法选取2018年7月至2022年2月在十堰市妇幼保健院进行孕中期产前检查的孕妇2756例为研究对象,根据妊娠结局将孕妇分为先心病组(n=110),正常组(n=2646)。孕中期均行胎儿超声心动图检查。酶联免疫吸附法试验(enzymelinked immunosorbent assay,ELISA)检测母体血清SFRP5浓度,全自动生化分析仪检测Hcy浓度。Pearson法分析先心病组母体血清SFRP5浓度与Hcy浓度的相关性。以妊娠结局为“金标准”,分析胎儿超声心动图、母体血清SFRP5、Hcy浓度及三者联合对先心病胎儿的诊断效能。结果先心病组母体血清SFRP5浓度明显低于正常组(P<0.05),Hcy浓度明显高于正常组(P<0.05),两者浓度呈负相关(r=-0.575,P<0.05)。胎儿超声心动图、母体血清SFRP5、Hcy浓度诊断先天性心脏病胎儿的灵敏度分别为63.64%、64.55%、65.45%,特异度分别为81.52%、81.07%、80.35%,准确度分别为80.81%、80.41%、79.75%。胎儿超声心动图、母体血清SFRP5、Hcy浓度联合诊断先心病胎儿的灵敏度、准确度分别为96.36%、80.91%,均高于三者单独检测,且三者联合诊断的灵敏度显著高于三者单独诊断(P<0.05)。结论胎儿超声心动图联合母体血清SFRP5、Hcy浓度对先心病胎儿具有较高的诊断价值,三者联合诊断可提高灵敏度。
Objectives To analyze the diagnostic efficacy of fetal echocardiography combined with maternal serum concentrations of secreted frizzled-related protein 5(SFRP5)and homocysteine(Hcy)in fetuses with congenital heart disease.Methods From July 2018 to February 2022,2756 pregnant women who underwent second-trimester prenatal examination in Shiyan Maternal and Child Health Hospital,were regarded as the research objects.According to pregnancy outcomes,they were grouped into congenital heart disease group(110 cases)and normal group(2646 cases).Fetal echocardiography was performed during the second trimester,maternal serum concentration of SFRP5 was detected by enzyme-linked immunosorbent assay(ELISA).The serum concentration of Hcy was detected by an automatic biochemical analyzer.Pearson method was applied to analyze the correlations between maternal serum concentrations of SFRP5 and Hcy in CHD group.Taking pregnancy outcome as the"gold standard",the diagnostic efficacies of fetal echocardiography,maternal serum concentrations of SFRP5,Hcy and the combination of the three in fetuses with congenital heart disease was analyzed.Results The maternal serum concentration of SFRP5 in congenital heart disease group was obviously lower than that in normal group(P<0.05),and the serum concentration of Hcy was obviously higher than that in normal group(P<0.05).There was a negative correlation between the serum concentrations of SFRP5 and Hcy(r=-0.575,P<0.05).The sensitivity of fetal echocardiography,maternal serum concentrations of SFRP5 and Hcy in the diagnosis of fetuses with congenital heart disease was 63.64%,64.55%,and 65.45%,respectively,the specificity was 81.52%,81.07%,and 80.35%,and the accuracy was 80.81%,80.41%,and 79.75%,respectively.The sensitivity and accuracy of the combination of fetal echocardiography,maternal serum concentrations of SFRP5 and Hcy in diagnosing congenital heart disease in fetuses were 96.36% and 80.91%,respectively,which were higher than those of the three alone,and the sensitivity of the combined diagnosis of the three was obviously higher than that of the three alone(P<0.05).Conclusions Fetal echocardiography combined with maternal serum concentrations of SFRP5 and Hcy has high diagnostic value for fetuses with congenital heart disease,and the combined diagnosis of the three can improve the sensitivity.
作者
王琳
刘洋
罗卉丽
陈秀兰
袁学华
王隆
WANG Lin;LIU Yang;LUO Huili;CHEN Xiulan;YUAN Xuehua;WANG Long(Department of Laboratory,Shiyan Maternal and Child Health Hospital,Shiyan,Hubei 442000,China;Department of Pediatrics,Shiyan Maternal and Child Health Hospital,Shiyan,Hubei 442000,China)
出处
《岭南心血管病杂志》
CAS
2024年第2期176-180,共5页
South China Journal of Cardiovascular Diseases
