胎儿NT联合血清PAPP-A、ADAM12检测在唐氏综合征产前筛查中的临床应用

邵菊; 姜智明; 林燕

doi:10.13898/j.cnki.issn.1000-2200.2021.02.029

胎儿NT联合血清PAPP-A、ADAM12检测在唐氏综合征产前筛查中的临床应用

The appplication value of the combination detection of fetal NT and serum PAPP-A, ADAM12 in the prenatal screening of DS

摘要

摘要:
目的分析胎儿颈部半透明层厚度（NT）超声联合血浆相关蛋白A（PAPP-A）、解整合素-金属蛋白酶12（ADAM12）检测在唐氏综合征（DS）产前筛查的临床价值。
方法选取323名接受早期孕检的孕妇作为研究对象，所有产妇于孕11~14周行B超检查NT，并在孕15~21周行血清PAPP-A、ADAM12检测，比较NT、PAPP-A、ADAM12单项检测及联合检测DS的结果。
结果NT检测结果显示高危孕妇15例，血清PAPP-A检测高危孕妇19例，血清ADAM12检测高危孕妇20例，NT联合血清PAPP-A及ADAM12检测高危孕妇6例，其中NT检测漏诊2例，PAPP-A检测漏诊2例，血清ADAM12检测漏诊1例。NT联合PAPP-A及ADAM12诊断的敏感度、准确度、特异度、阴性预测值、阳性预测值显著高于NT、血清PAPP-A、ADAM12单独检测（P < 0.05）。NT、血清PAPP-A及ADAM12单独检测及联合检测的ROC曲线下面积分别为0.802、0.729、0.762、0.905，联合检测的ROC曲线面积高于NT、血清PAPP-A及ADAM12单独检测（P < 0.05）。
结论采用NT联合血清PAPP-A、ADAM12检测产前筛查DS可明显提升其检出率，具有很好的临床应用价值。

Abstract:
ObjectiveTo explore of the clinical value of transthoracic thickness(NT)ultrasound combined with levels of plasma associated protein A(PAPP-A)and disintegrin-metalloproteinase 12(ADAM12)in the prenatal screening of Down's syndrome(DS).
MethodsThree hundred and twenty-three women with pregnancy 11 to 14 weeks were examined using B-ultrasound, and the serum levels of PAPP-A and ADAM12 at 15 to 21 weeks of gestation were measured.The results between the single detection of NT, PAPP-A and ADAM12, and combination detection of NT, PAPP-A and ADAM12 in the diagnsois of DS were compared.
ResultsFifteen, 19, 20 and 6 high-risk pregnant women were identified using the single detection of NT, PAPP-A and ADAM12, and combination detection of NT, PAPP-A and ADAM12, respectively.Two, 2 and 1 cases were missed diagnosis using the detetcion of NT, PAPP-A and ADAM12, respectively.The sensitivity, accuracy, specificity, negative predictive value and positive predictive value of the combination detection of NT, PAPP-A and ADAM12 were significantly higher than those of single of NT, serum PAPP-A and ADAM12(P < 0.05).The areas under the ROC of the single detection of NT, serum PAPP-A and ADAM12, and combination detection were 0.802, 0.729, 0.762 and 0.905, respectively.The ROC curve area of the combination detection was significantly higher than that of single detetcion of NT, serum PAPP-A and ADAM12(P < 0.05).
ConclusionsThe combination detection of NT, serum PAPP-A and ADAM12 can significantly improve the detection rate of DS, and has good clinical value.

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