超声检查与母体血清学联合检测筛查胎儿先天性心脏病

摘要

Objective To discuss the value of the measurement of nuchal translucency (NT) thickness,tricuspid regurgitation (TR) and ductus venosus (DV) doppler waveform by ultrasonic testing at early pregnancy and maternal serum alpha-fetoprotein (AFP) and free β-human chorionic gonadotropin (free-β-HCG) at mid-pregnancy in screening of fetal congenital heart diseases (CHD).Methods A total of 2,632 pregnant women from December 2010 to February 2016 were selected.In 11-14 weeks of pregnancy,a combination of NT ≥3 mm,TR and abnormal blood flow waveform of DV was considered as high-risk signs.The levels of maternal serum AFP and free-β-HCG were detected during 15-21 gestational weeks.The risk was assessed by the software of analysis system,and the risk rate ≥ 1/270 was designed as high risk.Results The result of combined detection in screening of fetal CHD was significantly different from that of ultrasound examination or maternal serological detection (P ＜ 0.05).Conclusions Fetal NT,TR,DV and maternal serological abnormalities suggest a potential risk of fetal CHD,and the combination of ultrasound examination and maternal serological detection can increase the detection rate of CHD.%目的 探讨于孕早期颈项透明层厚度(NT)、三尖瓣反流(TR)与动脉导管(DV)和孕中期母体血清甲胎蛋白(AFP)、游离β绒毛膜促性腺激素(free-β-HCG)检测在筛查胎儿先天性心脏病(CHD)中的意义和作用.方法 对2010年12月-2016年2月于该院就诊的单胎孕妇共2 632例,于孕11～14周时进行产前诊断时行超声检查,3项超声检查均异常视为高危;所有孕妇亦于孕15～21周进行母血清标志物AFP和free-β-HCG测定,风险率≥1/270为血清学筛查高危.并对所有孕妇进行随访.对超声检查高危、血清学筛查高危与两者联合筛查均高危结果进行比较.结果 分别比较超声检查、血清学检测2种检测结果,差异无统计学意义;联合筛查与超声检查、血清学检测结果比较,差异有统计学意义(P＜0.05).结论 胎儿NT、TR、DV及母体血清学检测异常提示胎儿存在潜在的CHD的风险,超声检查联合血清学检查能提高CHD的检出率.