超声软指标在胎儿染色体异常筛查中的应用价值

目的 探讨各项超声软指标在胎儿染色体异常筛查中的临床应用价值.方法 回顾性分析513例超声检查发现软指标阳性但未合并明确结构畸形的单胎妊娠孕妇资料,应用二元Logistic回归分析超声软指标与胎儿染色体异常的相关性,绘制受试者工作特征(ROC)曲线分析各项超声软指标对染色体异常的筛查价值.结果 513例胎儿中,单项超声...

Application value of the ultrasonic soft indexes in the diagnosis of fetal chromosomal abnormalities

Objective To explore the clinical application value of the ultrasonic soft indexes in the diagnosis of fetal chromosomal abnormalities.Methods The data of 513 cases of single pregnancy with positive soft indexes but no definite structural malformation were retrospectively analyzed.The correlation between ultrasonic soft indexes and fetal chromosomal abnormalities was analyzed by binary Logistics regression,and the receiver operating characteristic(ROC)curve was drawn to analyze the screening value of ultrasonic soft indexes for chromosomal abnormalities.Results Among the 513 fetuses,there were 457 fetuses with single positive ultrasonic soft index,and 56 fetuses with two or more positive ultrasonic soft indexes.The overall incidence of chromosomal abnormalities was 17.74%(91/513),and the incidence of chromosomal abnormalities in fetuses with two or more ultrasonic soft indexes positives was 28.57%(16/56),which was higher than that in fetuses with single positives ultrasonic soft index(16.41%,75/457),and the difference was statistically significant(P<0.05).Binary logistic regression analysis showed that the screening value of nuchal translucency(NT)thickening,abnormal nasal bone and single umbilical artery for chromosomal abnormalities were significantly higher than that of other ultrasonic soft indexes(all P<0.05),the sensitivity were 46.2%,20.9%,17.6%,the specificity were 86.5%,90.8%,88.2%,and the area under the curve were 0.663,0.558,0.529,respectively.The area under the curve of combined application of NT thickening,abnormal nasal bone and single umbilical artery was 0.751,which was statistically significant compared with the single ultrasonic soft index(P<0.05).Conclusion In the cases with positive ultrasonic soft indexes,the NT thickening,abnormal nasal bone and single umbilical artery screening for chromosomal abnormality are of high value,and the combined application of these three can improve the diagnostic efficiency.