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胎儿颈后透明层截断值的超声测量分析
陈 姝
云南省第一人民医院遗传诊断中心
摘要:
[摘要]目的 探讨超声对云南全省范围内胎儿颈后透明层(Nuchal translucency ) 截断值的诊断价值.方法 利用彩色多普勒超声诊断仪(GE Volusion E8)的四维容积探头对1 000 例来自云南全省范围内的年龄在20~45岁、孕11周~13+6周的孕妇进行胎儿颈后透明层标准测量.结果 在获得的所有NT标准测量值中,有97例超声发现有胎儿和/或其附属物异常,是NT值超过英国胎儿医学基金会规定的NT截断值2.7 mm,占9.7%,而这97例孕妇中仅有30例年龄在35岁或以下,其余67例孕妇年龄均在35岁以上.对这97例孕妇的追踪随访调查发现,有64例孕妇的胎儿出现了除NT增厚外的其它超声指标,占66%,对这97例孕妇均进行了介入性检查及诊断,有49例染色体正常,有48例证实有染色体异常,其中18例为21-三体综合征,对这48例孕妇进行了引产手术,术后胎儿和超声对照证实有多发畸形;而其他染色体正常的49例胎儿出生后有17例有先天性缺陷,其余32例随访至今未发现明显异常.结论 以第95百分位数2.7 mm作为云南全省范围内年龄在20~45岁、孕11周~孕13+6 d的孕妇之胎儿的NT截断值比较具有可靠性,年龄在35岁或以上的孕妇怀有NT增厚的胎儿及染色体异常的胎儿的机率要高于年龄在35岁以下的孕妇
关键词:  [关键词]彩色多普勒超声  孕11周~13+6周  颈后透明层  染色体异常  畸形  截断值
DOI:
分类号:
基金项目:
Determination of the Cut-off Value of Transparent Layer of Fetal Neck by Ultrasound
CHEN Shu
Abstract:
[Abstract]Objective To investigate ultrasound cut-off value of transparent layer of fetal neck(Nuchal translucency)in Yunnan Province.Method Standard measurements of fetal nuchal translucency were performed in 1 000 females aged 20 to 45 from Yunnan province, with pregnancies of 11-13 +6 weeks through Color Doppler Ultrasonography with four-dimensional volume probe. Results Among all cases,abnormalities of fetal and appendicities were detected by ultrasound in 97 cases,and,or their NT value exceeds the cut-off value of NT, 2.7,provided by the Fetal Medicine Foundation of UK,with the percentage of 9.7%,while the 30 of the 97 cases of pregnant women aged 35 years or less,the remaining 67 aged more than 35 years.The survey follow up to the 97 cases of pregnant women found that 64 cases of fatal,about 66%,appeared other sonographic abnomalities in addition to NT thickening,such as neck hygroma,ect,and the 97 cases of pregnant women were given invasive examination and diagnosis,there were 49 cases of normal chromosomes,48 patients were proved to have chromosome abnormalities,of which 18 cases of 21 - trisomy syndrome.The 48 cases of pregnant women with chromosome abnormalities were given surgical abortion,and fetal ultrasound were confirmed after a number of malformations,through which we found that the highest detection rate of chromosomal abnormalities was 21 - trisomy syndrome by NT thickening.while 17 of the 49 cases wiht normal chromosome showed congenital defects after birth,chromosomal normalities were not found in the 17 cases, and follow-up showed that there were no significant abnormalities in the remaining 32 cases.Conclusions 2.7mm to 95th percentile range as the cut-off value of NT is more reliable for the fetus of pregnant women in 20-45 years of age,and with 11 weeks - 11 weeks + 6 days of pregnancy in Yunnan Province.The data also show that pregnant women over 35 years have more risks to harbor fetus with NT thickness and chromosomal abnormalities than pregnant women under 35 years
Key words:  [Key words]Color doppler ultrasound  Pregnancies of 11 weeks to 13+6 weeks  Nuchal translucency  Chromosomal abnormality,Deformity,Cut-off value