超声心动图联合孕妇血清β-hCG、N-proBNP水平检测对胎儿先天性心脏病的早期诊断价值-东南大学学报医学版

超声心动图联合孕妇血清β-hCG、N-proBNP水平检测对胎儿先天性心脏病的早期诊断价值

单位：1. 北京核工业医院超声科, 北京 102413;
2. 北京核工业医院妇产科, 北京 102413

分类号：R714.5

出版年·卷·期（页码）：2025·44·第一期（138-143）

摘要：

目的:探讨超声心动图联合血清人绒毛膜促性腺激素(β-hCG)、氨基末端脑利钠肽前体(N-proBNP)对胎儿先天性心脏病的诊断价值。方法:选取2020年6月至2022年5月于北京核工业医院产检的436例孕妇为研究对象,将胎儿患有先天性心脏病的40例孕妇作为研究组,胎儿发育正常的396例孕妇作为对照组。采用酶联免疫吸附实验检测血清β-hCG、N-proBNP水平。采用受试者工作特征(ROC)曲线评价血清β-hCG、N-proBNP对胎儿心脏病的诊断价值,Logistic回归分析胎儿心脏病发生的影响因素。采用决策曲线(DCA)评价超声心动图、血清β-hCG、血清N-proBNP联合诊断胎儿心脏病的临床实用性。结果:研究组血清β-hCG水平低于对照组,N-proBNP水平高于对照组,差异均有统计学意义(均P＜0.05);超声心动图、β-hCG、N-proBNP检测诊断胎儿心脏病的AUC分别为0.751、0.885、0.900,三者联合检测的AUC为0.963,高于单项指标检测(P＜0.05);Logistic回归分析显示,血清β-hCG、N-proBNP水平均是胎儿心脏病的影响因素(P<0.05)。结论:血清β-hCG、N-proBNP水平检测联合超声心动图检查可在一定程度上提高胎儿先天性心脏病诊断效能,降低误诊及漏诊风险。

Objective: To investigate the diagnostic value of echocardiography combined with serum amino-terminal brain natriuretic peptide precursor(N-proBNP) and human chorionic gonadotropin(β-hCG) for fetal congenital heart disease. Methods:A total of 436 pregnant women who received prenatal examination in Beijing Nuclear Industry Hospital from June 2020 to May 2022 were selected as the research objects, among whom 40 pregnant women with fetal congenital heart disease were allocated into study group, and 396 pregnant women with normal fetal development into control group. Serum β-hCG and N-proBNP levels were detected by enzyme-linked immunosorbent assay. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of serum β-hCG and N-proBNP in fetal heart disease, and the influencing factors of fetal heart disease were analyzed by multiple Logistic regression. Decision curve(DCA) was used to evaluate the clinical practicability of the combination of echocardiography, serum β-hCG and N-proBNP in the diagnosis of fetal heart disease. Results:The serum expression level of N-proBNP in the study group was higher than that in the control group, and the serum expression level of β-hCG in the study group was lower than that in the control group, with statistically significant differences(all P<0.05); the AUC of fetal heart disease detected by echocardiography, β-hCG and N-proBNP was 0.751, 0.885 and 0.900, respectively, the AUC of the three combined detection was 0.963, which was higher than that of the single index detection(P<0.05); the results of multiple Logistic regression analysis showed that the levels of serum β-hCG and N-proBNP were the factors affecting fetal heart disease(P<0.05). Conclusion:The detection of serum β-hCG and N-proBNP levels combined with echocardiography can improve the diagnostic efficiency of fetal heart disease and reduce the risks of misdiagnosis and missed diagnosis to a certain extent.

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