地中海贫血高危胎儿的产前超声诊断临床应用价值

摘要

目的：观察地中海贫血高危胎儿的二维超声表现,探讨超声在地中海贫血高危胎儿产前诊断中的应用价值。方法选取2009年6月至2013年6月在广西壮族自治区民族医院行胎儿产前超声检查有异常表现,且地中海贫血基因检查诊断为地中海贫血的孕20~28周单胎儿82例为地中海贫血组,选择同时期行孕期常规产前超声检查及地中海贫血基因检查正常的孕20~28周单胎儿86例为正常胎儿组。记录两组胎儿超声检查的表现,如胎儿心脏横径、胸腔横径、心胸比值、脐动脉内径、脐静脉内径及脐动静脉内径比值等指标,比较两组胎儿超声检测结果并进行统计分析。结果地中海贫血胎儿组的心脏横径、胸腔横径、心胸比值、脐静脉内径均显著大于正常胎儿组[(22.30±3.10)mmvs(16.70±3.01)mm,(43.50±5.70)mmvs(35.10±6.30)mm,(0.51±0.02)vs (0.46±0.02),(4.98±0.58) mm vs (3.82±0.64) mm,P<0.01]；脐动静脉内径比值显著小于正常胎儿组[(0.52±0.03) vs (0.66±0.06),P<0.01]。产前超声检查对地中海贫血组胎儿的正确诊断率为92.3%,对正常组胎儿组的正确诊断率为69.4%,地中海贫血组胎儿的诊断率显著高于正常组胎儿组,差异有统计学有意义(P<0.05)。结论产前超声检查可提高地中海贫血高危胎儿的筛查率,检查方法安全、有效,适合在基层医院推广。%Objective To analyze the two-dimensional ultrasound performance imaging of fetus of thalassemia high-risk fetusthalassemia,and to investigate the diagnosis value of two-dimensional ultrasound in the prenatal diagnosis of thalassemia. Methods Between June 2009 and June 2013,in Guangxi Minzhu Hospital,82 case of single fetus at 20-28 weeks who had abnormal two-dimensional ultrasound performance and were confirmed of thalassemia by gene tests were chosen for the study group,and at the same period rou-tine pregnancy in hospital,86 case of single fetus at 20-28 weeks with normal results in ultrasound perform-ance and thalassemia gene tests of thalassemia were chosen for the control group. The performances of ultra-sound of the two groups were recorded,such as the heart transverse diameter,chest diameter,cardiothoracic ratio,and the diameter of fetal umbilical artery and umbilical vein,the diameter ratio of umbilical artery/vein,etc. And the ultrasound results of the two groups were compared for statistical analysis. Results The Heart transverse diameter,chest diameter,cardiothoracic ratio,diameter of fetal umbilical vein of thalassemia group were obviously larger than those of control group,there were statisticalsignificance[(22. 30 ± 3. 10) mm vs (16. 70 ± 3. 01) mm,(43. 50 ± 5. 70) mm vs (35. 10 ± 6. 30) mm,(0. 51 ± 0. 02) vs (0. 46 ± 0. 02),(4.98 ±0.58) mm vs (3.82 ±0.64) mm,P<0.01] ,the diameter ratio of fetal umbilical artery/vein of thalassemia group was obviously lower than those of control group,there was statistical significance [(0.52 ±0.03)vs(0.66 ±0.06),P<0.01] . Prenatal ultrasound examination of the fetal diagnosis of thalassemia group was 92. 3%,the correct diagnosis of normal fetal group rate was 69. 4%,the diagnosis rate of fetal thalassemia group was significantly higher than the normal group fetus group (P<0. 05),statistically meaningful. Conclusion Prenatal ultrasound can increase the screening rates of thalassemia high-risk fetus, inspection method is safe,effective,suitable for use in primary hospitals .