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目的 探讨早孕期胎儿NT增厚和鼻骨异常在诊断胎儿染色体异常中的价值。方法 取头臀长在45~84mm的胎儿的正中矢状切面,测量胎儿NT厚度和观察鼻骨情况,结合孕妇血清学筛查及孕妇年龄评估染色体异常的风险,得出高危病例,建议其做羊膜腔穿刺术,与染色体检查结果比较,评估NT增厚、鼻骨异常在筛查胎儿染色体异常中的价值。结果 以NT增厚预测胎儿染色体异常的阳性预测值是15.93%,以鼻骨异常预测胎儿染色体异常的阳性预测值是40.00%,两者联合预测胎儿染色体异常的阳性预测值55.56%。P<0.05,差异有统计学意义。结论 胎儿NT增厚和鼻骨发育异常与胎儿染色体异常有较高的相关性,是早孕期超声检出染色体异常的重要指标,两者联合,可进一步提高胎儿染色体异常的检出率,对胎儿染色体异常的筛查具有重要的指导意义。
Objective To study the value of nuchal translucency(NT) thickness and nasal bone(NB) abnormal in diagnosis of fetal chromosomal abnormalities at first trimester of pregnancy. Method Crown rump length was measured between 45 ~ 84 mm in the center of the fetal sagittal section, then the thickness of nuchal translucency(NT) and the status of nasal bone were detected. Combined with maternal serological screening and the age of pregnant women, the risk of chromosomal abnormalities was evaluated, for high-risk cases, there was suggestion for amniocentesis.NT thickness and nasal bone abnormalities were evaluated in the value of screening fetal chromosomal abnormalities with the results of chromosome examination as comparison. Results The PPV of NT thickness for predicting fetal chromosomal abnormality was 15.93%, for nasal bone(NB) absence, the PPV was 40.00%. Combined both of them to predict fetal chromosomal abnormalities, the PPV was 55.56%. P<0.05, the differences are statistically significant. Conclusions NT thickness and nasal bone dysplasia have higher relation with fetal chromosomal abnormalities, there are important indicators for chromosome abnormalities in the first trimester. Combined NT and nasal bone, it can further improve the detection rate of fetal chromosomal abnormalities, and it has great value of fetal chromosomal abnormalities screening.
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