汉族和维族胎儿NT的差异性分析及其联孕妇血清学的临床应用

发布时间：2018-06-03 06:58

本文选题：颈项透明层 + 胎儿　；参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：探讨汉族和维族正常单胎胎儿颈项透明层(nuchal translucency, NT)是否存在差异性及其正常值范围并评估颈项透明层联合孕妇血清学筛查胎儿染色体异常的临床价值。方法：选取在我院行NT检查的正常单胎8161例,其中汉族5025例,维族3136例对不同孕周维族和汉族胎儿NT进行分析,采用线性回归计算不同孕周胎儿的NT厚度的第5%、50%、95%位数,并对3106名孕11-13+6周行胎儿NT测量且另于孕14-20周行血清游离雌三醇(UE3)、甲胎蛋白(AFP)、游离绒毛膜促性腺激素β亚基(Free β?-HCG)检测的结果与妊娠结局相对照,分析颈项透明层和孕妇血清学及其与胎儿染色体的关系,并建立受试者工作特性曲线(ROC曲线)。结果：孕11-13+6周汉族与维族相同孕周的孕妇年龄及胎儿NT厚度间差异均无统计学意义(P0.05),孕13+6周汉族与维族胎儿的第95%位数均为0.22cm,染色体异常胎儿的NT及孕妇血清学与染色体正常组胎儿比较,差异均有统计学意义(P0.05),以胎儿颈项透明层0.22cm为鉴别胎儿染色体异常的诊断界点,则诊断敏感度、特异度分别为77.43%、99.05%,以孕妇血清学超过1/270为鉴别胎儿染色体异常的诊断界点,则诊断敏感度、特异度分别为85.71%、95.85%,两者联合诊断的敏感度、特异度分别为100%、99.7%,差异均有统计学意义(P＜0.05), ROC曲线下面积(area under the curve, AUC)四者分别为0.830、0.866、0.903、0.995。结论：妊娠11-13+6周,汉族和维族胎儿NT值不存在民族差异性,就本地区而言把NT正常值设定在0.22cm是行之有效的,胎儿颈项透明层联合孕妇血清学对胎儿染色体异常及其他畸形的筛查优于单独应用。
[Abstract]:Objective: To investigate the difference and normal range of nuchal translucency (NT) in the normal single fetus of the Han and Uygur single fetuses and to evaluate the clinical value of the screening of abnormal fetal chromosomes by the clear layer of the cervical layer combined with pregnant women. Methods: 8161 cases of normal single fetus were selected in our hospital with NT examination, of which 5025 cases were Han and vitamin D. The NT of the Uygur and Han fetuses of different gestational weeks was analyzed in 3136 ethnic groups. The 5%, 50% and 95% figures of the NT thickness of different gestational fetus were calculated by linear regression, and the fetal NT was measured in 3106 pregnancy 11-13+6 weeks and the serum free female three alcohol (UE3), AFP and free chorionic gonadotropin beta subunit (Free beta -HCG) were performed at the 14-20 week of pregnancy. The results of the test were compared with the pregnancy outcome, and the relationship between the clear layer of the neck and the serology of pregnant women and their fetal chromosomes was analyzed, and the working characteristic curves of the subjects (ROC curve) were established. The results showed that there was no significant difference between the pregnant women of the Han and the Uygurs at the same pregnancy 11-13+6 weeks and the NT thickness of the fetus (P0.05), and the Han nationality was pregnant 13+6 weeks. The 95% digit number of the Uygur fetus was 0.22cm, the NT of abnormal fetal chromosomes and the maternal serology and the normal chromosome group were statistically significant (P0.05). The diagnostic sensitivity of the fetal neck transparent layer 0.22cm was the diagnostic point of fetal chromosomal abnormalities, and the specificity of the diagnostic sensitivity was 77.43%, 99.05%, respectively. The diagnostic sensitivity of more than 1/270 to identify fetal chromosomal abnormalities was 85.71% and 95.85%, respectively. The sensitivity of the combined diagnosis was 100% and 99.7% respectively (P < 0.05). The area under the ROC curve (area under the curve, AUC) four were 0.830,0.866,0.903,0.995. knots, respectively. On the 11-13+6 weeks of pregnancy, the NT values of the Han and Uygur fetus do not exist in national differences. It is effective to set the normal value of NT in the region in the region of 0.22cm. The screening of fetal neck translucent layer and pregnant women's serology is superior to the screening of fetal chromosomal abnormalities and other malformations.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.5

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