超声多参数联合评分在甲状腺功能异常孕妇的新生儿甲状腺功能异常的预测价值
Journal of China Clinic Medical Imaging（2023）
江苏省中西医结合医院
Abstract
目的:探讨包括胎儿甲状腺形态学及血流分布、胎儿心率、骨成熟度在内的超声多参数联合评分在甲状腺功能异常孕妇的新生儿出现甲状腺功能异常的预测价值.方法:选取2017年1月—2021年12月在江苏省中西医结合医院超声科进行胎儿甲状腺功能评估的85例临床诊断为甲状腺功能异常的孕妇,在常规进行胎儿甲状腺形态学及血流分布检查的基础上,进一步进行胎儿心率测量、胎儿骨成熟度检测.出生后抽血检查新生儿甲状腺功能,了解是否出现新生儿甲状腺功能异常.将单纯应用超声观察胎儿甲状腺形态学及血流(方法1),以及将胎儿甲状腺形态学及血流分布检查联合胎儿心率测量、胎儿骨成熟度检测进行多参数评分(方法2)两种方法分别对新生儿甲状腺功能情况进行评估.采用受试者操作特征(ROC)曲线法评估并比较2种评估方法对甲状腺功能异常孕妇宫内胎儿出生后发生新生儿甲状腺功能异常的预测价值.结果:单纯评估形态法(方法1)和联合评分法(方法2)阳性组的新生儿甲状腺功能异常发生率均明显高于相应的阴性组,差异均有统计学意义(P＜0.001).预测出现新生儿甲状腺功能异常发生风险时,单纯胎儿甲状腺形态学及血流评分,胎儿甲状腺形态学及血流分布检查联合胎儿心率测量,胎儿骨成熟度检测,胎儿宫内运动监测联合评分ROC曲线下面积(AUC)值分别是0.715和0.918,两者间差异存在统计学意义(Z=2.361,P=0.018 2).两种方法的特异性、准确性以及阳性预测值的差异存在统计学意义.结论:超声多参数联合评分法在预测新生儿发生甲状腺功能异常的准确率较高,具有一定临床价值.
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Key words
Thyroid Gland,Ultrasonography,Prenatal
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