CAJ | 학술논문

目的探讨孕11~14 周胎儿静脉导管A波倒置在胎儿染色体异常筛查中的临床应用价值. 方法对11~14周的孕妇行常规产前检查,并进行静脉导管血流频谱和颈项透明层厚度检测. 随访A波倒置或颈项透明层增厚胎儿的羊水穿刺培养染色体核型检查结果. 结果 656例胎儿中,共28例异常,其中静脉导管A波倒置21例,颈项透明层增厚19例,两者共同异常12例;随访28例胎儿染色体核型,其中17例染色体异常,14例21-三体,2 例18-三体,1 例9号染色体结构异常;DV-RAW对胎儿染色体异常敏感性为82. 35%,特异性为36. 36%,准确度为64. 29%;而NT增厚方法胎儿染色体异常敏感性为76. 47%,特异性为45. 45%,准确度为64. 29%;DV-RAW联合NT作为诊断指标,敏感性为58. 82%,特异性为81. 82%,准确度为67. 86%. 结论 11~14周胎儿静脉导管A波倒置可作为胎儿染色体异常的早期筛查指标,能协助早期诊断胎儿染色体核型异常.
목적 탐토잉11~14 주태인정맥도관A파도치재태인염색체이상사사중적림상응용개치. 방법 대11~14주적잉부행상규산전검사,병진행정맥도관혈류빈보화경항투명층후도검측. 수방A파도치혹경항투명층증후태인적양수천자배양염색체핵형검사결과. 결과 656례태인중,공28례이상,기중정맥도관A파도치21례,경항투명층증후19례,량자공동이상12례;수방28례태인염색체핵형,기중17례염색체이상,14례21-삼체,2 례18-삼체,1 례9호염색체결구이상;DV-RAW대태인염색체이상민감성위82. 35%,특이성위36. 36%,준학도위64. 29%;이NT증후방법태인염색체이상민감성위76. 47%,특이성위45. 45%,준학도위64. 29%;DV-RAW연합NT작위진단지표,민감성위58. 82%,특이성위81. 82%,준학도위67. 86%. 결론 11~14주태인정맥도관A파도치가작위태인염색체이상적조기사사지표,능협조조기진단태인염색체핵형이상.
Objective To explore the clinical application value of the reversed A-wave in fetal ductus venosus assessed by ultrasound at 11~14 weeks gestation on screening fetal chromosomal abnormalities. Methods Regular antenatal examination was performed on pregnant women of 11~14 weeks gestation. The Doppler spectrum of the ductus venosus and the size of nuchal trans-lucency were conducted. The results of amniotic fluid puncture cultivate karyotype examination and the DV-RAW or NT thickening were followed up. Results Among 656 cases,DV-RAW were found in 21 cases,NT thickening were found in 19 cases,both in abnormalities were found in 12 cases. After followed-up of fetal chromosomal karyotype in 28 cases, chromosomal abnormalities were found in 17 cases,the trisomy 21 syndrome were found in 14 cases,Edwards' syndrome were found in 2 cases and 9 chromo-some structural abnormality was found only in 1 case. The sensitivity of DV-RAW in the detection of fetal chromosomal abnormali-ties was 82. 35%,the specificity was 36. 36% and the accuracy was 64. 29%. The sensitivity of NT thickening method in fetal chromosomal abnormalities was 76. 47%,the specificity was 45. 45% and the accuracy was 64. 29%. When combined the DV -RAW and NT methods,the diagnostic sensitivity was 58. 82%,the specificity was 81. 82% and the accuracy was 67. 86%. Con-clusion The reversed A-wave in fetal ductus venosus at 11~14 weeks gestation showed to be helpful in the early screening for fe-tal chromosomal abnormalities,and might help the early diagnosis of fetal abnormal chromosome karyotype.