CAJ | 학술논문

目的:探讨胎儿宫内贫血母血AFP(MSAFP)水平和胎儿大脑中动脉收缩期血流峰值(MCA-PSV)的相关性并用胎儿血红蛋白(FHB)值验证其相关性,评价MSAFP和MCA-PSV对胎儿贫血病例的临床预测和监护意义.方法: 对32例怀疑有胎儿贫血病例(自体免疫性胎儿贫血4例, 地中海贫血11例,B19微小病毒感染10例,胎盘血管瘤7例)进行55次MSAFP和MCA-PSV测量,对于MCA-PSV异常病例抽取脐带血,共获得19份胎儿血液标本,测定FHB含量.结果: MSAFP与MCA-PSV有相关性(n=55,r=0.57,P<0.01).19例胎儿血标本检查共15例贫血标本,其中4例假阳性病例的MSAFP正常.贫血胎儿的MSAFP明显高于非贫血胎儿,地中海贫血和免疫溶血性贫血病例MSAFP升高比MCA-PSV升高早15-20 d,B19病毒感染和胎盘血管瘤导致的贫血病例MSAFP升高则比MCA-PSV晚10-12 d(P<0.05).MSAFP(r=-0.87)和MCA-PSV(r=-0.67)与FHB水平有相关性.结论: 胎儿宫内贫血时MSAFP水平升高的时间和程度比MCA-PSV的变化更具有预测和监护意义,而且两者间呈相关性.因此,MSAFP和MCA-PSV可能是临床预测和监护不同程度胎儿宫内贫血最有价值的联合测量指标.
목적:탐토태인궁내빈혈모혈AFP(MSAFP)수평화태인대뇌중동맥수축기혈류봉치(MCA-PSV)적상관성병용태인혈홍단백(FHB)치험증기상관성,평개MSAFP화MCA-PSV대태인빈혈병례적림상예측화감호의의.방법: 대32례부의유태인빈혈병례(자체면역성태인빈혈4례, 지중해빈혈11례,B19미소병독감염10례,태반혈관류7례)진행55차MSAFP화MCA-PSV측량,대우MCA-PSV이상병례추취제대혈,공획득19빈태인혈액표본,측정FHB함량.결과: MSAFP여MCA-PSV유상관성(n=55,r=0.57,P<0.01).19례태인혈표본검사공15례빈혈표본,기중4례가양성병례적MSAFP정상.빈혈태인적MSAFP명현고우비빈혈태인,지중해빈혈화면역용혈성빈혈병례MSAFP승고비MCA-PSV승고조15-20 d,B19병독감염화태반혈관류도치적빈혈병례MSAFP승고칙비MCA-PSV만10-12 d(P<0.05).MSAFP(r=-0.87)화MCA-PSV(r=-0.67)여FHB수평유상관성.결론: 태인궁내빈혈시MSAFP수평승고적시간화정도비MCA-PSV적변화경구유예측화감호의의,이차량자간정상관성.인차,MSAFP화MCA-PSV가능시림상예측화감호불동정도태인궁내빈혈최유개치적연합측량지표.
AIM: To evaluate the relationships between maternal serum alpha-fetoprotein (MSAFP) levels and middle cerebral artery peak systolic velocity (MCA-PSV) in pregnancies with fetal anaemia and to compare the sensitivities of MSAFP and MCA-PSV for the predicting the risk of fetal anaemia. METHODS: Fifty-five measurements of MSAFP and MCA-PSV were carried out in 32 women at risk of fetal anaemia (4 cases of alloimmunisation, 11 cases of thalassemia, 10 cases of parvovirus infection and 7 cases of placental chorioangioma). The relationship between MSAFP and MCA-PSV was studied, and 19 fetal blood samples, in which MCA-PSV measurements were abnormal, were taken and the fetal heamoglobin were tested in order to evaluate the correlation of MSAFP and MCA-PSV. RESULTS: A correlation between MSAFP and MCA-PSV (n=55, r=0.57, P<0.01) was observed, in which 15 cases of fetal anaemia and 4 cases false positive (non-anaemia) were detected among the 19 fetal blood samples. The MSAFP levels of 4 false-positive cases were normal. The MSAFP levels in 15 fetal anaemia cases were higher than those in non-anaemia. The elevation of MSAFP level was 15-20 d earlier than that of MCA-PSV in the cases of alloimmunisation and thalassemia, and it was 10-12 d later in the cases of parvovirus infection and placental chorioangioma significantly (P<0.05). Both MSAFP (r=-0.87) and MCA-PSV (r=-0.67) were significantly correlated with fetal heamoglobin level. CONCLUSION: The MSAFP level is significantly correlated with both MCA-PSV measurements and fetal haemoglobin. The time and process of the elevations of MSAFP indicate that MSAFP is more sensitive than MCA-PSV to predict and monitor the pregnancies at the risk of fetal anaemia.