超声测量颈项透明层厚度对孕早期胎儿畸形的筛查价值
|
摘要
目的探讨超声测量颈项透明层厚度在孕早期胎儿畸形筛查中的应用价值。方法选取2014年1月‐2016年8月在该院超声科就诊的16 078例11～13+6周孕妇作为研究对象。测量胎儿的颈项透明层厚度,通过查阅病历或电话随访获得妊娠结局,探讨超声测量颈项透明层厚度在孕早期胎儿畸形筛查中的应用价值。结果染色体及发育均正常15 965例(99.30%);染色体异常或结构发育异常共113例(0.70%),其中染色体异常66例(0.41%),染色体正常而结构发育异常47例(0.29%)。异常胎儿的颈项透明层厚度分布:颈项透明层厚度≥2.4 mm 67例,其中染色体异常5例,占7.46%(5/67);结构异常45例,占67.16%(45/67)。颈项透明层厚度<2.4 mm 16 011例,其中染色体异常61例,占0.38%(61/16 011);结构异常2例,占0.01%(2/16 011)。结论 11～13~(+6)孕周胎儿颈项透明层厚度随孕周(顶臀长)的增大而增厚、与孕妇年龄无相关性;胎儿颈项透明层≥2.4 mm,其染色体或结构异常的发生率大大增加。
【Objective】To investigate the value of ultrasound measurement of nuchal translucency(NT) thickness in screening fetal malformation in the first trimester.【Methods】From January 2014 to August 2016, 16078 pregnant women aged 11～13+6 weeks in Zhuhai Maternal and Children Health Hospital were selected as the subjects. The thickness of cervical transparent layer was measured, pregnancy outcomes were obtained by consulting medical records or telephone follow-up, and the value of ultrasonic measurement of cervical clear layer thickness in early pregnancy fetal malformation screening was evaluated.【Results】Of the16078 cases of 11～13+6 weeks, 15965 cases were normal chromosome and structure(99.30%), while chromosomal or structural abnormalities were found in 113 cases(0.70%). Chromosomal abnormalities were found in 66 cases; normal chromosomal but structural abnormalities were found in 47 cases. Distribution of NT values in abnormal fetus: during 16078 cases, the thickness of the nuchal translucency greater than or equal to 2.4 mm was found in 67 cases, including 5 cases of chromosomal abnormality, accounting for 7.46%(5/67); 45 cases of normal chromosome but structural abnormalities, accounting for 67.16%(45/67). The thickness of the nuchal translucency less than 2.4 mm was found in 16011 cases, including 61 cases of chromosomal abnormalities, accounting for 0.38%(61/16011); 2 cases of structural abnormalities, accounting for 0.01%(2/16011).【Conclusion】The thickness of nuchal translucency layer at 11～13+6 weeks of gestation increased with gestational age(the crown rump length), and had no correlation with the age of the pregnant women; the incidence of chromosomal or structural abnormalities is greatly increased when the thickness of the nuchal translucency was greater than or equal to 2.4 mm.
【Objective】To investigate the value of ultrasound measurement of nuchal translucency(NT) thickness in screening fetal malformation in the first trimester.【Methods】From January 2014 to August 2016, 16078 pregnant women aged 11～13+6 weeks in Zhuhai Maternal and Children Health Hospital were selected as the subjects. The thickness of cervical transparent layer was measured, pregnancy outcomes were obtained by consulting medical records or telephone follow-up, and the value of ultrasonic measurement of cervical clear layer thickness in early pregnancy fetal malformation screening was evaluated.【Results】Of the16078 cases of 11～13+6 weeks, 15965 cases were normal chromosome and structure(99.30%), while chromosomal or structural abnormalities were found in 113 cases(0.70%). Chromosomal abnormalities were found in 66 cases; normal chromosomal but structural abnormalities were found in 47 cases. Distribution of NT values in abnormal fetus: during 16078 cases, the thickness of the nuchal translucency greater than or equal to 2.4 mm was found in 67 cases, including 5 cases of chromosomal abnormality, accounting for 7.46%(5/67); 45 cases of normal chromosome but structural abnormalities, accounting for 67.16%(45/67). The thickness of the nuchal translucency less than 2.4 mm was found in 16011 cases, including 61 cases of chromosomal abnormalities, accounting for 0.38%(61/16011); 2 cases of structural abnormalities, accounting for 0.01%(2/16011).【Conclusion】The thickness of nuchal translucency layer at 11～13+6 weeks of gestation increased with gestational age(the crown rump length), and had no correlation with the age of the pregnant women; the incidence of chromosomal or structural abnormalities is greatly increased when the thickness of the nuchal translucency was greater than or equal to 2.4 mm.
引文
[1]Iuculano A,Pagani G,Stagnati V,et al.Pregnancy outcome and long-term follow-up of fetuses with isolated increased NT:a retrospective cohort study[J].J Perinat Med,2016,44(2):237-242.
[2]杨艾妮,张涛,朵丽梅.产前系统超声诊断胎儿畸形[J].深圳中西医结合杂志,2016,26(23):69-70.
[3]邬素英,曹炎,赖育美.超声检查对孕11-13+6周胎儿畸形的诊断价值[J].中国医学创新,2016,13(1):92-95.
[4]Lee SM,Kwon JE,Song SH,et al.Prenatal prediction of neonatal death in single ventricle congenital heart disease[J].Prenat Diagn,2016,36(4):346-352.
[5]Paolino A,Hussain T,Pavon A,et al.NT-proBNP as marker of ventricular dilatation and pulmonary regurgitation after surgical correction of tetralogy of fallot:a MRI validation study[J].Pediatr Cardiol,2017,38(2):324-331.
[6]张欢,孙世雨.规范化系统产前超声对筛查胎儿畸形的价值[J].继续医学教育,2017,31(2):144-145.
[7]王丽春,梁喜,张屹辉,等.早孕期NT增厚联合鼻骨异常在筛查胎儿染色体异常中的价值[J].中国产前诊断杂志(电子版),2015,7(2):17-20.
[8]孙丽敏,王平.四维彩超在诊断胎儿畸形中的应用价值[J].中国卫生标准管理,2016,7(36):142-143.
[9]刘姜伶.超声测量胎儿颈项透明层在检出胎儿异常发育的临床诊断价值[J].现代诊断与治疗,2016,27(2):365-366.
[10]Lithner CU,Kublickas M,Ek S.Pregnancy outcome for fetuses with increased nuchal translucency but normal karyotype[J].JMed Screen,2016,23(1):1-6.
[11]Passeri E,Rigolini R,Costa E,et al.Serum NT-proBNP levels are not related to vitamin D status in young patients with congenital heart defects[J].Dis Markers,2016,36(4):346-352.
[12]Feliciano M,Uscategui RR,Maciel GS,et al.Serum levels of cardiac markers NT-proANP and NT-proBNP in brachycephalic bitches at different gestational stages[J].Reprod Domest Anim,2016,51(3):346-350.
[13]任静,陈爱军,李扬,等.超声诊断单纯性羊水过多在评价胎儿畸形、宫内转归及预后中的价值[J].中国妇幼保健,2017,32(5):1064-1066.
[14]秦晓娜.B超探测颈项透明层厚度在胎儿畸形筛查中的作用[J].中国妇幼保健,2017,32(5):1077-1079.
[2]杨艾妮,张涛,朵丽梅.产前系统超声诊断胎儿畸形[J].深圳中西医结合杂志,2016,26(23):69-70.
[3]邬素英,曹炎,赖育美.超声检查对孕11-13+6周胎儿畸形的诊断价值[J].中国医学创新,2016,13(1):92-95.
[4]Lee SM,Kwon JE,Song SH,et al.Prenatal prediction of neonatal death in single ventricle congenital heart disease[J].Prenat Diagn,2016,36(4):346-352.
[5]Paolino A,Hussain T,Pavon A,et al.NT-proBNP as marker of ventricular dilatation and pulmonary regurgitation after surgical correction of tetralogy of fallot:a MRI validation study[J].Pediatr Cardiol,2017,38(2):324-331.
[6]张欢,孙世雨.规范化系统产前超声对筛查胎儿畸形的价值[J].继续医学教育,2017,31(2):144-145.
[7]王丽春,梁喜,张屹辉,等.早孕期NT增厚联合鼻骨异常在筛查胎儿染色体异常中的价值[J].中国产前诊断杂志(电子版),2015,7(2):17-20.
[8]孙丽敏,王平.四维彩超在诊断胎儿畸形中的应用价值[J].中国卫生标准管理,2016,7(36):142-143.
[9]刘姜伶.超声测量胎儿颈项透明层在检出胎儿异常发育的临床诊断价值[J].现代诊断与治疗,2016,27(2):365-366.
[10]Lithner CU,Kublickas M,Ek S.Pregnancy outcome for fetuses with increased nuchal translucency but normal karyotype[J].JMed Screen,2016,23(1):1-6.
[11]Passeri E,Rigolini R,Costa E,et al.Serum NT-proBNP levels are not related to vitamin D status in young patients with congenital heart defects[J].Dis Markers,2016,36(4):346-352.
[12]Feliciano M,Uscategui RR,Maciel GS,et al.Serum levels of cardiac markers NT-proANP and NT-proBNP in brachycephalic bitches at different gestational stages[J].Reprod Domest Anim,2016,51(3):346-350.
[13]任静,陈爱军,李扬,等.超声诊断单纯性羊水过多在评价胎儿畸形、宫内转归及预后中的价值[J].中国妇幼保健,2017,32(5):1064-1066.
[14]秦晓娜.B超探测颈项透明层厚度在胎儿畸形筛查中的作用[J].中国妇幼保健,2017,32(5):1077-1079.