超声NT联合母体血清PTEN、galectin-3对胎儿心脏畸形的早期诊断价值OA

Objective:To explore the early diagnostic value of ultrasound nuchal translucency(NT)combined with maternal serum phosphatase and tensin homolog(PTEN)and galectin-3 for fetal cardiac abnormalities.Methods:A total of 112 pregnant women with suspected fetal cardiac abnormalities admitted to Jianyang People's Hospital from August 2020 to August 2023 were selected.Using pathological results of induced labor or neonatal echocardiography as the"gold standard",the subjects were divided into the malformation group(23 cases)and the normal group(89 cases).Enzyme-linked immunosorbent assay was used to detect serum markers.The diagnostic efficacy was analyzed by receiver operating characteristic curves,and DeLong test was applied to compare differences in the area under the curve(AUC).Results:Compared with the normal group,the malformation group had significantly higher NT value[(2.26±0.62)mm vs.(1.57±0.44)mm,P＜0.001]and galectin-3 level[(7.54±1.28)ng/mL vs.(5.57±1.14)ng/mL,P＜0.001],while the PTEN level was significantly lower[(11.36±2.94)ng/mL vs.(15.45±3.67)ng/mL,P＜0.001].The AUC of the combined diagnosis reached 0.945(95％CI:0.885～0.979),which was significantly superior to that of single-item detection(NT:0.807,Z=2.124,P=0.034;PTEN:0.814,Z=2.896,P=0.004;galectin-3:0.847,Z=2.313,P=0.021).The optimal cut-off value combination was NT ≥1.85 mm+PTEN≤11.63 ng/mL+galectin-3 ≥7.15 ng/mL,with a sensitivity of 95.65％and a specificity of 83.15％.Conclusion:The combination of ultrasound NT,serum PTEN and galectin-3 detection can significantly improve the early diagnostic efficacy of fetal cardiac abnormalities in the first trimester.The AUC of the combined model is 0.945,providing a high-specificity combined detection protocol for clinical screening.