摘要
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=0.0182)。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。
Objective:To explore the predictive value of multi-parameter combined score of ultrasound including fetal thyroid size,Doppler signals,heart rate and bone maturation in the neonatal thyroid dysfunction of pregnant women with thyroid dysfunction.Methods:A total of 85 cases of pregnant women with thyroid dysfunction were recruited from our hospital from January 2017 to December 2021.The fetal thyroid size,Doppler signals,heart rate and bone maturation were measured with ultrasound.Thyroid function was evaluated at birth.Patients were evaluated with fetal thyroid size and Doppler signals with ultrasound(method 1)and ultrasound multi-parameter scoring including fetal thyroid size,Doppler signals,heart rate and bone maturation(method 2).The receiver operating characteristic(ROC)curve method was used to evaluate and compare the predic-tive value of the two scoring systems for neonatal thyroid dysfunction of pregnant women with thyroid dysfunction.Results:The incidence of neonatal thyroid dysfunction in method 1 positive group and method 2 positive group was significantly higher than that in the negative group,and the difference was with statistical significance(P<0.001).When predicting the risk of neonatal thyroid dysfunction,the area under ROC curve(AUC)values of method 1 and method 2 were 0.715 and 0.918 respectively,and the differences were with statistical significance(Z=2.361,P=0.0182).The difference of specificity,accuracy,and positive predictive value of two methods was statistically significant.Conclusion:Multi-parameter combined score of ultrasound was of high accuracy for prediction of abnormal thyroid function in neonates,therefore having good clinical value.
作者
李素娟
丁文波
武心萍
邓学东
LI Su-juan;DING Wen-bo;WU Xin-ping;DENG Xue-dong(Department of Ultrasound,Jiangsu Province Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing 210028,China;Center of Medical Ultrasound,Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou Municipal Hospital,Suzhou Jiangsu 215002,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2023年第4期259-262,共4页
Journal of China Clinic Medical Imaging
基金
中国中医科学院江苏分院课题(JSBN1313)。
关键词
甲状腺
超声检查
产前
Thyroid Gland
Ultrasonography,Prenatal
作者简介
李素娟(1984-),女,广东湛江人,副主任医师。E-mail:1771924183@qq.com;通信作者:邓学东,南京医科大学附属苏州医院苏州市立医院超声中心,215002。E-mail:xuedongdeng@163.com。
