中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2011年
2期
74-77
,共4页
蒋涛%孙亦骏%徐倩君%孙云%张晓娟%曹荔%查文%张瑾%黄美莲%陈春华%林远珊%许争峰
蔣濤%孫亦駿%徐倩君%孫雲%張曉娟%曹荔%查文%張瑾%黃美蓮%陳春華%林遠珊%許爭峰
장도%손역준%서천군%손운%장효연%조려%사문%장근%황미련%진춘화%림원산%허쟁봉
唐氏综合征%超声检查,产前%甲胎蛋白类%绒毛膜促性腺激素,β亚单位,人
唐氏綜閤徵%超聲檢查,產前%甲胎蛋白類%絨毛膜促性腺激素,β亞單位,人
당씨종합정%초성검사,산전%갑태단백류%융모막촉성선격소,β아단위,인
Down syndrome%Ultrasonography,prenatal%alpha-Fetoproteins%Chorionic gohadotropin beta subunit,human
目的 探讨中孕期二联法产前筛查唐氏综合征(Down's syndrome,DS)的有效性.方法 回顾性分析1997年11月至2008年5月期间,在南京市妇幼保健院自愿接受采用时间分辨荧光免疫法检测血清甲胎蛋白(alpha-fetoprotein,AFP)+游离β-绒毛膜促性腺激素(beta subunit of human chorionic gonadotropin,β-hCG)二联法产前筛查60 931例孕妇中,妊娠结局为DS的50例孕中期(15～20+6周)筛查结果.结果 50例DS妊娠中,以游离β-hCG≥2.5 MoM为标准,DS共检出25例,检出率为50.0%,筛查阳性率为6.6%;以AFP≤0.5 MoM为标准,共检出DS 9例,检出率为18.0%,筛查阳性率为4.6%;当DS风险率高危切割值定为1/270时,检出率为52.0%,筛查阳性率为4.7%;如定为1/300时,DS检出率为62.0%,筛查阳性率为5.5%.风险值位于1/1000～1/300的DS妊娠共有13例,其中有2例单项指标异常.50例DS妊娠中经中孕期胎儿结构系统B超检查发现有一种或多种异常指标的共有13例,占26.0%,其中12例血清二联筛查结果 为高风险,1例为低风险.结论 AFP+游离β-hCG二联产前筛查可以有效检出DS妊娠,但特异性和敏感性均有待提高,结合单项指标异常可以增加DS妊娠检出率.中孕期胎儿结构系统B超检查对DS妊娠检出率较低,但可以提高血清学产前筛查的特异性和敏感性.
目的 探討中孕期二聯法產前篩查唐氏綜閤徵(Down's syndrome,DS)的有效性.方法 迴顧性分析1997年11月至2008年5月期間,在南京市婦幼保健院自願接受採用時間分辨熒光免疫法檢測血清甲胎蛋白(alpha-fetoprotein,AFP)+遊離β-絨毛膜促性腺激素(beta subunit of human chorionic gonadotropin,β-hCG)二聯法產前篩查60 931例孕婦中,妊娠結跼為DS的50例孕中期(15～20+6週)篩查結果.結果 50例DS妊娠中,以遊離β-hCG≥2.5 MoM為標準,DS共檢齣25例,檢齣率為50.0%,篩查暘性率為6.6%;以AFP≤0.5 MoM為標準,共檢齣DS 9例,檢齣率為18.0%,篩查暘性率為4.6%;噹DS風險率高危切割值定為1/270時,檢齣率為52.0%,篩查暘性率為4.7%;如定為1/300時,DS檢齣率為62.0%,篩查暘性率為5.5%.風險值位于1/1000～1/300的DS妊娠共有13例,其中有2例單項指標異常.50例DS妊娠中經中孕期胎兒結構繫統B超檢查髮現有一種或多種異常指標的共有13例,佔26.0%,其中12例血清二聯篩查結果 為高風險,1例為低風險.結論 AFP+遊離β-hCG二聯產前篩查可以有效檢齣DS妊娠,但特異性和敏感性均有待提高,結閤單項指標異常可以增加DS妊娠檢齣率.中孕期胎兒結構繫統B超檢查對DS妊娠檢齣率較低,但可以提高血清學產前篩查的特異性和敏感性.
목적 탐토중잉기이련법산전사사당씨종합정(Down's syndrome,DS)적유효성.방법 회고성분석1997년11월지2008년5월기간,재남경시부유보건원자원접수채용시간분변형광면역법검측혈청갑태단백(alpha-fetoprotein,AFP)+유리β-융모막촉성선격소(beta subunit of human chorionic gonadotropin,β-hCG)이련법산전사사60 931례잉부중,임신결국위DS적50례잉중기(15～20+6주)사사결과.결과 50례DS임신중,이유리β-hCG≥2.5 MoM위표준,DS공검출25례,검출솔위50.0%,사사양성솔위6.6%;이AFP≤0.5 MoM위표준,공검출DS 9례,검출솔위18.0%,사사양성솔위4.6%;당DS풍험솔고위절할치정위1/270시,검출솔위52.0%,사사양성솔위4.7%;여정위1/300시,DS검출솔위62.0%,사사양성솔위5.5%.풍험치위우1/1000～1/300적DS임신공유13례,기중유2례단항지표이상.50례DS임신중경중잉기태인결구계통B초검사발현유일충혹다충이상지표적공유13례,점26.0%,기중12례혈청이련사사결과 위고풍험,1례위저풍험.결론 AFP+유리β-hCG이련산전사사가이유효검출DS임신,단특이성화민감성균유대제고,결합단항지표이상가이증가DS임신검출솔.중잉기태인결구계통B초검사대DS임신검출솔교저,단가이제고혈청학산전사사적특이성화민감성.
Objective To approach the efficiency of second-trimester prenatal screening using two serum markers for Down's syndrome (DS).Methods Retrospective analysis was conducted on the results of prenatal screening using two serum markers,alpha fetoprotein (AFP) and free beta subunit of human chorionic gonadotropin(free-β-hCG),in 50 cases of DS pregnancy identified among 60 931 pregnant women received prenatal screening from November 1997 to April 2008 in Nanjing Maternal and Child Health Hospital.Results Among the 50 DS cases,the detection rate of DS was 50% (25/50) when taking free-β-hCG≥2.5 MoM as the cut-off,with the positive rate of screening was 6.6%.And the detection rate of DS would be 18.0%(9/25) when taking AFP≤0.5 MoM as the cut-off,with the positive rate of screening was 4.6%.When the risk cut-off value of DS was set at 1/270,the detection rate changed to 52.0%,and the positive rate of screening was 4.7%;and the two figures changed to 62.0% and 5.5%,respectively,when the risk cut-off was set to 1/300.Thirteen DS cases showed the risk value between 1/1000 and 1/300,among which two were monomarker abnormality.Thirteen (26.0%) of the 50 DS fetus were found to have one or two abnormality markers by ultrasound scan,among which one was DS low risk,and the other 12 were DS high risk in serum screening.Conclusions The second-trimester prenatal screening using AFP or free β-hCG for Down's syndrome is effective in identifying DS pregnancy with limited specificity and sensitivity.But the detection rate can be elevated by the combination of these two markers.The second trimester systemic ultrasound scan is not ideal for DS identification,but it can increase the specificity and sensitivity of serum prenatal screening.
