超声omniview技术联合血清AFP、ApPrx2诊断胎儿神经管缺陷的价值及临床意义

doi:10.3969/j.issn.1007-3205.2021.11.014

河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (11): 1307-1311.doi: 10.3969/j.issn.1007-3205.2021.11.014

超声omniview技术联合血清AFP、ApPrx2诊断胎儿神经管缺陷的价值及临床意义

四川省达州市中医结合医院超声医学科，四川达州 635000

出版日期:2021-11-25 发布日期:2021-11-29
作者简介:杨昕宇（1977-），女，四川巴中人，四川省达州市中医结合医院副主任医师，医学学士，从事产前超声诊断研究。
基金资助:
四川省卫生和计划生育科研课题资助项目（18PJ025）

The value and clinical significance of ultrasonic omniview technology combined with serum AFP and ApPrx2 in the diagnosis of fetal neural tube defects

Department of Ultrasound Medicine, Dazhou Hospital of Integrated Traditional Chinese Medicine, Sichuan Province, Dazhou 635000, China

Online:2021-11-25 Published:2021-11-29

摘要/Abstract

摘要： 目的探讨超声自由解剖平面（omniview）技术联合血清甲胎蛋白（alpha-fetoprotein，AFP）、过氧化物氧化还原酶2（peroxiredoxin-2，ApPrx2）诊断胎儿神经管缺陷（neural tube defects，NTD）的价值及临床意义。
方法选取在我院接受规律产检的孕妇3 107例，其中30例胎儿NTD（观察组），3 077例非胎儿NTD（对照组），统计超声omniview技术检出胎儿NTD情况，比较两组一般资料、血清AFP、ApPrx2 mRNA，采用Logistic回归方程分析胎儿NTD的相关影响因素，采用受试者工作特征（receiver operating characteristic，ROC）曲线及ROC下面积（ area under ROC,AUC）分析血清AFP、ApPrx2诊断胎儿NTD的价值。
结果以临床随访结果为“金标准”，超声omniview技术诊断胎儿NTD的敏感度为90.00%（27/30），特异度为100.00%（3 077/3 077），准确率为99.90%（3 104/3 107）；观察组血清AFP、ApPrx2 mRNA较对照组显著升高（P＜0.05）；Logistic回归方程分析显示，超声omniview结果异常者胎儿NTD的风险可能是正常者的4.230倍，有放射线接触史者胎儿NTD的风险可能是无接触史者的2.897倍，AFP≥103.96 μg/L者胎儿NTD的风险可能是＜103.96 μg/L者的2.148倍，ApPrx2 mRNA≥1.03者胎儿NTD的风险可能＜1.03者的1.731倍（P＜0.05）；血清AFP、ApPrx2 mRNA诊断胎儿NTD的AUC分别为0.863、0.900。
结论超声omniview技术、血清AFP、ApPrx2 mRNA均对胎儿NTD有一定诊断价值，三者联合有望提高诊断效能，对提升出生人口质量具有重要价值。

关键词: 神经管缺损, 甲胎蛋白, 超声检查

Abstract: Objective To investigate the value and clinical significance of ultrasonic omniview technology combined with serum alpha-fetoprotein(AFP) and peroxiredoxin-2(ApPrx2) in the diagnosis of fetal neural tube defects(NTD).
Methods A total of 3 107 pregnant women who received regular check-ups in our hospital were selected, including 30 with fetal NTD(observation group) and 3 077 with non-fetal NTD(control group). The fetal NTD detected by ultrasonic omniview technology was calculated, and the general data, serum AFP and ApPrx2 mRNA of the two groups were compared. The Logistic regression equation was used to analyze the related influencing factors of fetal NTD, and the receiver operating characteristic curve(ROC) and area under ROC(AUC) were used to analyze the value of serum AFP and ApPrx2 in the diagnosis of fetal NTD.
Results Taking clinical follow-up results as the “gold standard”, the sensitivity of ultrasonic omniview technology in diagnosing fetal NTD was 90.00%(27/30), the specificity was 100.00%(3 077/3 077), and the accuracy rate was 99.90%(3 104/3 107). Serum AFP and ApPrx2 mRNA in the observation group were significantly higher than those in the control group(P＜0.05). The Logistic regression equation analysis showed that the risk of fetal NTD in patients with abnormal ultrasonic omniview results was approximately 4.230 times that of normal patients, and the risk of fetal NTD in patients with a history of radiation exposure was approximately 2.897 times that of those without exposure history. The risk of fetal NTD with AFP≥103.96 μg/L was approximately 2.148 times that of those with＜103.96 μg/L, and the risk of fetal NTD with ApPrx2 mRNA≥1.03 was approximately 1.731 times that of those with ApPrx2 mRNA≥1.03(P＜0.05). The AUC of serum AFP and ApPrx2 mRNA to diagnose fetal NTD was 0.863 and 0.900, respectively.
Conclusion Ultrasonic omniview technology, serum AFP, and ApPrx2 mRNA have certain diagnostic value for fetal NTD. The combination of the three is expected to improve the diagnostic efficiency and is of great value for improving the quality of the birth population.

Key words: neural tube defect, alpha-fetoprotein, ultrasound examination

杨昕宇, 叶茜, 郭江. 超声omniview技术联合血清AFP、ApPrx2诊断胎儿神经管缺陷的价值及临床意义[J]. 河北医科大学学报, 2021, 42(11): 1307-1311.

YANG Xin-yu, YE Qian, GUO Jiang. The value and clinical significance of ultrasonic omniview technology combined with serum AFP and ApPrx2 in the diagnosis of fetal neural tube defects[J]. Journal of Hebei Medical University, 2021, 42(11): 1307-1311.

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超声omniview技术联合血清AFP、ApPrx2诊断胎儿神经管缺陷的价值及临床意义

The value and clinical significance of ultrasonic omniview technology combined with serum AFP and ApPrx2 in the diagnosis of fetal neural tube defects

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