血清GATA6和SMAD3表達(dá)水平對(duì)孕中期胎兒心血管畸形的診斷價(jià)值

［摘 要］目的 探究孕中期孕婦血清GATA結(jié)合6（GATA6）、SMAD同源物3（SMAD3）表達(dá)水平對(duì)胎兒心血管畸形的診斷價(jià)值。方法 選取2017年6月至2023年6月北部戰(zhàn)區(qū)總醫(yī)院收治的有高危胎兒心血管畸形風(fēng)險(xiǎn)的孕中期孕婦203例作為研究對(duì)象，根據(jù)隨訪結(jié)果，45例孕婦胎兒確診為心血管畸形（疾病組），158例孕婦胎兒心臟發(fā)育正常（對(duì)照組）。采用熒光定量PCR法和酶聯(lián)免疫吸附（ELISA）法分別檢測(cè)孕中期孕婦血清GATA6 mRNA、SMAD3表達(dá)水平。受試者工作特征（ROC）曲線(xiàn)分析孕中期孕婦血清GATA6 mRNA、SMAD3對(duì)胎兒心血管畸形的診斷價(jià)值。結(jié)果 疾病組孕婦血清GATA6 mRNA、SMAD3表達(dá)水平均低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（t值分別為4.210、7.185，P＜0.05）；孕中期孕婦血清GATA6 mRNA、SMAD3二者聯(lián)合診斷胎兒心血管畸形的曲線(xiàn)下面積（AUC）為0.95，優(yōu)于各自單獨(dú)診斷（Z值分別為5.41、5.23，P＜0.05）；聯(lián)合診斷的靈敏度和特異度分別為97.78%、79.11%。結(jié)論 胎兒心血管畸形的孕中期孕婦血清GATA6 mRNA、SMAD3表達(dá)水平均較低，二者聯(lián)合檢測(cè)對(duì)胎兒心血管畸形有較好的診斷價(jià)值。

［關(guān)鍵詞］GATA結(jié)合6；SMAD同源物3；孕中期；胎兒心血管畸形；診斷價(jià)值

Doi：10.3969/j.issn.1673-5293.2024.09.014

［中圖分類(lèi)號(hào)］R173""" ［文獻(xiàn)標(biāo)識(shí)碼］A

［文章編號(hào)］1673-5293（2024）09-0088-06

The diagnostic value of serum GATA6 and SMAD3 expression levels for fetal

cardiovascular malformations in the second trimester of pregnancy

［Abstract］ Objective To explore the diagnostic value of serum GATA binding 6 （GATA6） and SMAD homolog 3 （SMAD3） expression levels in the second trimester of pregnancy for fetal cardiovascular malformations. Methods A total of 203 pregnant women with high-risk fetal cardiovascular malformations in the second trimester who were admitted to the General Hospital of Northern Theater Command from June 2017 to June 2023 were selected as the study objects.According to the follow-up results，45 pregnant womens fetuses were diagnosed with cardiovascular malformations （disease group），and 158 pregnant womens fetuses with normal heart development （control group）.The expression levels of GATA6 mRNA and SMAD3 in the serum in the second trimester of pregnancy were detected using fluorescence quantitative PCR and enzyme-linked immunosorbent assay （ELISA） methods，respectively.The receiver operating characteristic （ROC） curve was used to analyze the diagnostic value of serum GATA6 mRNA and SMAD3 in the second trimester of pregnancy women for fetal cardiovascular malformations. Results The expression levels of serum GATA6 mRNA and SMAD3 in the disease group were lower than those in the control group，and the differences were statistically significant （t=4.210 and 7.185，respectively，P＜0.05）;The area under the curve （AUC） of the combined diagnosis of fetal cardiovascular malformations by serum GATA6 mRNA and SMAD3 in the second trimester was 0.95，which was better than the respective individual diagnoses （Z=5.41 and 5.23，respectively，P＜0.05）.The sensitivity and specificity of combined diagnosis were 97.78% and 79.11%，respectively. Conclusion The expression levels of serum GATA6 mRNA and SMAD3 in pregnant women with fetal cardiovascular malformations in the second trimester are low，and the combined detection of the two has a good diagnostic value for fetal cardiovascular malformations.

［Key words］ GATA binding 6;SMAD homolog 3;second trimester of pregnancy;fetal cardiovascular malformations;diagnostic value

胎兒心血管畸形是臨床醫(yī)學(xué)上多見(jiàn)的胎兒先天性畸形之一。據(jù)有關(guān)報(bào)道，胎兒心血管畸形約占先天性異常胎兒死亡率的30%，且是導(dǎo)致胎兒死亡的重要原因之一［1-2］。現(xiàn)在臨床上主要采用B超、磁共振成像檢測(cè)方法對(duì)胎兒心血管畸形進(jìn)行產(chǎn)前診斷，但檢測(cè)者操作水平容易影響診斷結(jié)果，有一定的局限性，且有的胎兒心血管畸形不易被發(fā)現(xiàn)，會(huì)導(dǎo)致誤診和漏診［3-4］。因此，聯(lián)合可靠的生物學(xué)指標(biāo)診斷胎兒心血管畸形，可降低漏診率。……