论文部分内容阅读
目的评价孕中期孕妇产前血清三联法筛查在唐氏综合征、18-三体综合征和开放性神经管缺陷中的临床应用。方法对965例孕15-21周的孕中期孕妇采用时间分辨免疫荧光法(DELFLA)测试血清甲胎蛋白(AFP)、游离人绒膜促性腺激素(freeβ-hCG)和游离性雌三醇(uE3),结合孕周、体重和年龄等因素,通过风险评估软件进行风险评估,并对结果进行分析。结果965例不同民族孕中期孕妇中筛查出高风险妊娠43例,阳性率为4.46%,其中唐氏综合症高风险者36例,18-三体综合征高风险者1例,单项MOM值异常者6例;高风险妊娠的民族分布如下:汉族40例,占93.02%;维族1例,占2.32%;回族1例,占2.32%;哈萨克族1例,占2.32%;蒙古族和锡伯族均未筛查出高风险妊娠;不同民族筛查出高风险妊娠的阳性率为:回族和哈萨克族最高(11.11%和14.28%),汉族和维族次之(4.40%和4.35%),蒙古族和锡伯族均未检出阳性(χ2=24.158,P=0.036)。结论通过AFP+β-hCG+uE3产前三联筛查能提高唐氏综合征、18-三体综合征和开放性神经管缺陷患儿的检出率,具有明显的经济效益和社会效益。
Objective To evaluate the clinical application of triple screening of prenatal serum in second trimester pregnancy in Down’s syndrome, 18-trisomy syndrome and open neural tube defects. Methods Serum AFP, free β-hCG and free estriol were measured in 965 pregnant women with gestational age of 15-21 weeks by using time-resolved immunofluorescence assay (DELFLA) uE3), combined with gestational age, body weight and age and other factors, through the risk assessment software risk assessment, and the results were analyzed. Results A total of 436 high-risk pregnancies were screened out from 965 pregnant women of different nationalities in the third trimester. The positive rate was 4.46%. Among them, 36 were high risk of Down’s syndrome, 1 was high risk of trisomy 18, 6 cases were abnormal, and the distribution of ethnic groups in high-risk pregnancy was as follows: 40 cases of Han, accounting for 93.02%; 1 case of Uygur, accounting for 2.32%; 1 case of Hui, accounting for 2.32%; Kazak 1 case, accounting for 2.32%; Mongolian and Xibe The highest positive rates of Hui and Kazak (11.11% and 14.28%), Han and Uygur (4.40% and 4.35%), Mongolia Neither family nor Xibe positive (χ2 = 24.158, P = 0.036). Conclusion Prenatal triple screening with AFP + β-hCG + uE3 can improve the detection rate of children with Down’s syndrome, 18-trisomy syndrome and open neural tube defects, with obvious economic and social benefits.