首页|血清HbF、AFP水平及BPS、Apgar评分诊断胎儿母体输血综合征的价值

血清HbF、AFP水平及BPS、Apgar评分诊断胎儿母体输血综合征的价值

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[目的]探讨孕产妇血清胎儿血红蛋白(HbF)、甲胎蛋白(AFP)联合胎儿生物物理评分(BPS)、阿氏评分(Apgar评分)诊断胎儿母体输血综合征(FMH)的价值.[方法]在本院门诊产检的 100 例疑似 FMH 的孕产妇作为研究对象,分娩后检测孕产妇血清 HbF、AFP 水平,并根据检查结果将孕产妇分为 FMH 组(13 例)和非FMH 组(87 例).比较两组孕产妇 HbF、AFP 水平及 BPS、Apgar 评分,通过受试者工作特征(ROC)曲线分析HbF、AFP及BPS、Apgar评分预测 FMH 的价值;多因素分析采取非条件 Logistic 逐步回归分析.[结果]FMH组患者 HbF、AFP水平显著高于非FMH 组,BPS、Apgar评分显著低于非FMH 组(均P<0.05);经ROC曲线分析显示,HbF、AFP及BPS、Apgar评分可用于发生FMH 的预测,曲线下面积分别为 0.897、0.810、0.829、0.941,联合诊断曲线下面积为 0.980;经多因素 Logistic回归分析证实,HbF≤3.712%、AFP≤588.359 ng/mL、BPS≥5.865分、Apgar评分≥5.968 分是发生 FMH 的危险因素.[结论]血清 HbF、AFP 联合 BPS、Apgar 评分可用于 FMH的早期诊断,且联合检测具有更好的评估效能.
The Value of Serum HbF,AFP Levels,BPS,Apgar Scores in Diagnosing Fetal Maternal Transfu-sion Syndrome
[Objective]To explore the value of serum fetal hemoglobin(HbF),alpha fetoprotein(AFP),combined with fetal biophysical score(BPS)and Apgar score in the diagnosis of fetal maternal transfusion syndrome(FMH)in pregnant and postpartum women.[Methods]A total of 100 pregnant and postpartum women suspected of FMH were se-lected as the study subjects in our outpatient department.After delivery,the serum HbF and AFP levels of pregnant and postpartum women were measured,and they were divided into FMH group(13 cases)and non FMH group(87 cases)based on the test results;We compared the HbF,AFP levels,BPS,and Apgar scores between two groups of pregnant women.The value of HbF,AFP,BPS,and Apgar scores in predicting FMH was analyzed using Receiver Operating Characteristic(ROC)curves;The multiple factor analysis adopted unconditional logistic stepwise regression analysis.[Results]The levels of HbF and AFP in the FMH group were significantly higher than those in the non FMH group,and the BPS and Apgar scores were significantly lower than those in the non FMH group(all P<0.05);According to ROC analysis,HbF,AFP,BPS,and Apgar scores can be used to predict the occurrence of FMH.The area under the curve was 0.897,0.810,0.829,and 0.941,respectively,and the area under thejoint diagnostic curve was 0.980;Multiple lo-gistic regression analysis confirmed that HbF≤3.712%,AFP≤588.359 ng/mL,BPS≥5.865 scores,and Apgar score≥5.96 scores were risk factors for the occurrence of FMH.[Conclusion]The combination of serum HbF,AFP,BPS,and Apgar score can be used for early diagnosis of FMH,and the combined detection has better evaluation efficacy.

Fetomaternal TransfusionFetal Hemoglobinalpha-FetoproteinsApgar Score

胡谢应、马雅莉、蒋晴晴、罗会涛、仲伟国、吴磊

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上海市长宁区妇幼保健院检验科,上海 200050

胎母输血综合征 胎儿血红蛋白 甲胎蛋白类 阿普加评分

2024

医学临床研究
湖南省医学会

医学临床研究

影响因子:0.595
ISSN:1671-7171
年,卷(期):2024.41(2)
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