| 颈项透明层厚度可作为胎儿不良围产结局的预测指标 |
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| 引用本文： | 翟科一, 陈艳, 邓琪. 颈项透明层厚度可作为胎儿不良围产结局的预测指标[J]. 分子影像学杂志, 2020, 43(3): 485-489. doi: 10.12122/j.issn.1674-4500.2020.03.24 |
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| 作者姓名： | 翟科一 陈艳 邓琪 |
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| 作者单位： | 绵阳市人民医院超声科，四川 绵阳 621000 |
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| 基金项目： | 国家科技支撑计划项目2014BA106B00 |
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| 摘 要： | 目的探索不同颈项透明层厚度（NT）与胎儿不良围产结局的关系。方法回顾性分析2017年3月~2019年3月于我院分娩的496例孕妇临床资料，筛选其中胎儿NT值异常的98例孕妇（单纯NT值增厚56例，妊娠不良结局42例）为研究对象，依据妊娠结局分为单纯胎儿NT值增厚组56例与妊娠不良结局组42例，对两组NT值、年龄、血清Freeβ-hCG异常率、NIPT染色体异常率进行对比；依据胎儿NT值异常增厚程度分为Ⅰ组：2.50~3.00 mm的，Ⅱ组：3.01~4.00 mm，Ⅲ组：4.01~5.00 mm，Ⅳ组： > 5.00 mm，对不良妊娠结局以及染色体异常发生率进行对比；利用Logistic回归分析法对胎儿围产结局、染色体异常的相关因素进行检验。结果本次研究共发现56例单纯NT值增厚患者，42例妊娠不良结局患者，妊娠不良结局发生率为42.86%；妊娠不良结局组NT值、年龄均大于单纯NT增厚组，妊娠不良结局组血清人绒毛膜促性腺激素游离β亚基（Freeβ-hCG）异常率、NIPT染色体异常率高于单纯NT增厚组（P < 0.05）。各不同胎儿NT值分组孕周、初产妇、BMI、长期吸烟史、糖尿病、高血压数据对比差异不具有统计学意义（P > 0.05）。Ⅰ、Ⅱ组正常胎儿占比高于Ⅲ、Ⅳ组，染色体异常发生率则较低（P < 0.05）。Logistic回归显示，NT值过度增加、年龄偏大、Freeβ-hCG异常及NIPT染色体异常是影响胎儿妊娠结局的危险因素（P < 0.05，OR > 1）；此外，NT值过度增加、年龄偏大是影响染色体异常的危险因素（P < 0.05，OR > 1），而Freeβ-hCG异常和染色体异常也有显著的关联影响关系（P < 0.05）。结论胎儿NT值能够作为胎儿围产期妊娠不良结局的预测指标，且胎儿NT值增加会提高胎儿发生妊娠不良结局的风险及胎儿染色体异常的发生率。
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| 关 键 词： | 颈项透明层厚度 不良结局 围产期 相关性 |
| 收稿时间： | 2020-03-12 |
Thickness of different neck transparent layers can be used as a predictor of outcome of fetal poor perinatal |
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| Keyi ZHAI, Yan CHEN, Qi DENG. Thickness of different neck transparent layers can be used as a predictor of outcome of fetal poor perinatal[J]. Journal of Molecular Imaging, 2020, 43(3): 485-489. doi: 10.12122/j.issn.1674-4500.2020.03.24 |
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| Authors: | Keyi ZHAI Yan CHEN Qi DENG |
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| Affiliation: | Department of Ultrasound, Mianyang People's Hospital, Mianyang 621000, China |
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| Abstract: | ObjectiveTo explore the relationship between the thickness of different cervical transparent layers (NT) and the outcome of fetal poor perinatal outcomes.MethodsThe clinical data of 496 pregnant women who were delivered in our hospital from March 2017 to March 2019 were retrospectively analyzed. Niety-eight pregnant women with abnormal fetal NT value were divided into 56 cases of pure fetal NT value thickening group and 42 cases of poor pregnancy outcome group according to pregnancy outcome. The NT value, age, serum Freeβ-hCG abnormal rate and NIPT chromosome abnormal rate were compared between the two groups. The value of abnormal thickening was divided into 4 groups of 2.50-3.00 mm group (group Ⅰ), 3.01-4.00 mm group (group Ⅱ), 4.01-5.00 mm group (group Ⅲ) and 5.00 mm group (group Ⅳ). The rates were compared. Logistic regression analysis was used to test the related factors of fetal perinatal outcomes and chromosomal abnormalities.ResultsA total of 56 patients with purely thickened NT values and 42 patients with poor pregnancy outcomes were found. The incidence of poor pregnancy outcomes was 42.86%. The NT value and age of the patients with poor pregnancy outcomes were significantly larger than those of the purely thickened NT patients. The abnormal rate of serum human chorionic gonadotropin free β-subunit (Freeβ-hCG) and the abnormal rate of NIPT chromosomes were significantly higher in the group than in the NT thickening group. The proportion of normal fetus in group Ⅰ was significantly higher than that in group Ⅱ, group Ⅲ and group Ⅳ. The incidence of fetal pregnancy in group Ⅲ was 100.00%, and the incidence of chromosomal abnormality was 71.43%, which was significantly higher than group Ⅰ and Ⅱ. The incidence of chromosomal abnormalities in the incidence of fetal pregnancy in group and group Ⅳ was significantly different (P < 0.05).ConclusionFetal NT value can be used as a predictor of fetal perinatal pregnancy outcome. The increase of fetal NT value will increase the risk of fetal adverse pregnancy outcome. The highest incidence of fetal chromosomal abnormalities between NT and 4.10-5.00 mm. |
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| Keywords: | neck transparent layer thickness adverse outcome perinatal period correlation |
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