CAJ | 학술논문

目的：评价孕11～13＋6周胎儿静脉导管搏动指数（DV－PIV）与肝动脉搏动指数（HA－PI）在唐氏早孕期联合筛查高风险孕妇中的应用价值。方法收集早孕期唐氏筛查高风险且颈项透明层（ NT）测量值正常的单胎孕妇223例作为观察组，同时收集早孕期唐氏筛查低风险、NT测量值正常且与观察组年龄、孕周相似的孕妇252例作为对照组，比较两组间胎儿DV－PIV和HA－PI的差异，比较观察组唐氏胎儿与对照组胎儿DV－PIV和HA－PI的差异，并采用受试者特征曲线（ ROC曲线）分析DV－PIV和HA－PI诊断21三体的价值。结果观察组胎儿DV－PIV显著高于对照组（P＜0.05），而两组胎儿HA－PI差异无统计学意义（P＞0.05）；观察组唐氏胎儿DV－PIV显著高于对照组胎儿（P＜0.05），而HA－PI显著低于对照组胎儿（P＜0.05）。 ROC曲线显示，DV－PIV（截断值为2.1）用于预测21三体的敏感性为86.1％，特异性为96.2％；HA－PI（截断值为1.0）用于诊断21三体的敏感性为70.9％，特异性为94.1％。结论早孕期唐氏筛查中增加DV－PIV和HA－PI的检测可提高唐氏综合征筛查的准确性。
목적：평개잉11～13＋6주태인정맥도관박동지수（DV－PIV）여간동맥박동지수（HA－PI）재당씨조잉기연합사사고풍험잉부중적응용개치。방법수집조잉기당씨사사고풍험차경항투명층（ NT）측량치정상적단태잉부223례작위관찰조，동시수집조잉기당씨사사저풍험、NT측량치정상차여관찰조년령、잉주상사적잉부252례작위대조조，비교량조간태인DV－PIV화HA－PI적차이，비교관찰조당씨태인여대조조태인DV－PIV화HA－PI적차이，병채용수시자특정곡선（ ROC곡선）분석DV－PIV화HA－PI진단21삼체적개치。결과관찰조태인DV－PIV현저고우대조조（P＜0.05），이량조태인HA－PI차이무통계학의의（P＞0.05）；관찰조당씨태인DV－PIV현저고우대조조태인（P＜0.05），이HA－PI현저저우대조조태인（P＜0.05）。 ROC곡선현시，DV－PIV（절단치위2.1）용우예측21삼체적민감성위86.1％，특이성위96.2％；HA－PI（절단치위1.0）용우진단21삼체적민감성위70.9％，특이성위94.1％。결론조잉기당씨사사중증가DV－PIV화HA－PI적검측가제고당씨종합정사사적준학성。
Objective To evaluate the applications of fatal ductus venosus pulsatility index of vein ( DV-PIV) and hepatic artery pulsatility index ( HA-PI) in Down syndrome screening for pregnant women at 11 -13 +6 weeks. Methods 223 women with singleton pregnancy with high risk for aneuploidy in combined screening test and normal nu-chal translucency ( NT) measurements were included as study group, and 252 women with similar age, gestational age, normal NT measurements and low-risk in first trimester combined tests were enrolled as control group.Fatal DV-PIV and HA-PI were compared between the two groups, while DV-PIV and HA-PI were compared between fetuses with Down syndrome in study group and fetuses in control group.Receiver operating characteristics ( ROC) curves were used to evaluate the capacities of fatal DV-PIV and HA-PI in the diagnosis of trisomy 21.Results Fatal DV-PIV was signif-icantly higher in study group ( P<0.05 ) , whereas no significant difference was revealed in fatal HA-PI ( P>0.05 ) . DV-PIV was significantly higher but HA-PI was significantly lower of fetuses with Down syndrome in study group when comparing with fetuses in control group (P<0.05).The sensitivity and specificity of DV-PIV in the diagnosis of trisomy 21, with the cutoff of 2.1, were 86.1%and 96.2%, respectively.The sensitivity and specificity of HA-PI in the diagno-sis of trisomy 21, with the cutoff of 1.0, were 70.9%and 94.1%, respectively.Conclusion The addition of DV-PIV and HA-PI measurements during the first trimester of pregnancy increases the accuracy for Down syndrome detection.