【摘要】 目的 探究胎儿大脑中动脉血流联合母体血清孕酮(PROG)、胎盘蛋白-13(PP-13)、血红素氧合酶-1(HO-1)对胎儿胼胝体发育不全的诊断价值。方法 选取2018年4月至2023年4月于唐山市妇幼保健院确诊为胎儿胼胝体发育不全的104例孕妇为研究组，同期在同院选择102例健康孕妇为对照组。采用酶联免疫吸附试验(ELISA)检测血清PROG、PP-13、HO-1水平；二维超声检测大脑中动脉搏动指数(PI)、阻力指数(RI)和收缩末期峰值流速(S)与舒张末期峰值流速(D)的比值(S/D)。受试者工作特征(ROC)曲线分析胎儿大脑中动脉血流联合母体血清PROG、PP-13、HO-1对胎儿胼胝体发育不全的诊断价值。结果 与对照组相比，研究组母体血清中PROG、PP-13水平降低，HO-1水平升高，差异有统计学意义(t值分别为7.702、10.329、6.439,P<0.05);与对照组相比，研究组胎儿大脑中动脉PI、RI值降低，差异有统计学意义(t值分别为9.565、8.726,P<0.05);两组S/D值比较差异无统计学意义(P>0.05);ROC曲线结果显示，PI、RI联合母体血清PROG、PP-13、HO-1对胎儿胼胝体发育不全诊断的曲线下面积(AUC)为0.981(95%CI:0.951～0.995),联合诊断的AUC显著高于单一指标诊断的AUC(Z值分别为5.848、5.453、5.415、5.122、5.899,P<0.001)。结论 胎儿胼胝体发育不全孕妇血清中孕酮、胎盘蛋白-13呈低表达，血红素氧合酶-1呈高表达，胎儿大脑中动脉血流联合母体血清孕酮、胎盘蛋白-13、血红素氧合酶-1对胎儿胼胝体发育不全有一定的诊断价值。更多还原

【Abstract】 Objective To explore the diagnostic value of fetal middle cerebral artery flow combined with maternal serum PROG,PP-13 and HO-1 in fetal agenesis of corpus callosum. Methods A total of 104 pregnant women diagnosed with fetal agenesis of corpus callosum in Tangshan Maternal and Child Health Hospital from April 2018 to April 2023 were selected as the study group, and 102 healthy pregnant women registered in the same hospital during the same period were selected as the control group.Enzyme linked immunosorbent assay(ELISA) was applied to detect serum levels of PROG,PP-13 and HO-1.Middle cerebral artery pulse index(PI),resistance index(RI) and the ratio of end-systolic peak flow rate(S) to end-diastolic peak flow rate(D)(S/D) were measured by two-dimensional ultrasound.Receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of fetal middle cerebral artery flow combined with maternal serum PROG,PP-13,HO-1 for fetal agenesis of the corpus callosum. Results Compared with the control group, the serum levels of PROG and PP-13 in the study group were significantly decreased, and the serum levels of HO-1 were significantly increased, and the difference was statistically significant(t=7.702,10.329,6.439,respectively, P<0.05).Compared with the control group, the fetal middle cerebral artery PI and RI were significantly decreased in the study group, and the differences were statistically significant(t=9.565,8.726,respectively, P<0.05)..There was no significant difference in the S/D value between the two groups(P>0.05).ROC curve results showed that the area under the curve(AUC) of PI,RI combined with maternal serum PROG,PP-13 and HO-1 in the diagnosis of fetal agenesis of the corpus callosum was 0.981(95%CI:0.951-0.995),and the AUC of combined diagnosis was significantly higher than that of single index diagnosis(Z=5.848,5.453,5.415,5.122,5.899,respectively, P<0.001). Conclusion The maternal serum of pregnant women with fetal agenesis of the corpus callosum showed low expression of PROG and PP-13 and high expression of HO-1.The combination of fetal middle cerebral artery blood flow and maternal serum PROG,PP-13 and HO-1 has certain diagnostic value for fetal agenesis of fetal agenesis of fetal callosum.更多还原