中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2012年
10期
932-935
,共4页
苗正友%石统昆%郭燕君%宋勤浩%沈华祥%徐营
苗正友%石統昆%郭燕君%宋勤浩%瀋華祥%徐營
묘정우%석통곤%곽연군%송근호%침화상%서영
妊娠初期%唐氏综合征%产前诊断%颈部透明带检查
妊娠初期%唐氏綜閤徵%產前診斷%頸部透明帶檢查
임신초기%당씨종합정%산전진단%경부투명대검사
Pregnancy trimester,first%Down syndrome%Prenatal diagnosis%Nuchal translucency measurement
目的 探讨孕早期利用颈项透明层厚度(NT),联合血清生化标志物游离β绒毛膜促性腺激素(Free-βhCG)、妊娠血浆相关蛋白A(PAPP-A)筛查DS敏感性.方法 收集2009年3月至2010年10月嘉兴学院附属妇幼保健院早孕建卡时自愿参加产前筛查的孕妇(年龄17～45岁),共计11 882例.分别于孕早期(11～13w+6d)测定孕妇血液中Free-βhCG、PAPP-A值,超声测定NT值；对于同一个体,利用风险计算软件,比较在孕早期NT、Free-βhCG、PAPP-A联合筛查和血清学Free-βhCG、PAPP-A筛查对唐氏综合征的检出率和特异性的异同,比较二种筛查方案的敏感性.结果 11 882例孕妇,共发现18例DS,发生率为0.15％.联合筛查和血清学筛查的检出率分别为83.3％、72.2％,特异性为98.4％、97.3％,检出效率为7.18％、3.90％.受试者工作特征曲线(ROC)曲线分析,孕早期联合筛查ROC曲线下的面积值(AUC)为0.975(95％ CCI:0.943,1.007),血清学筛查AUC为0.901(95％ CI:0.789,1.013).结论 孕早期联合筛查比血清学筛查DS有比较高敏感性和特异性,在相同的假阳性率情况下有较高检测率,可有效减少孕妇侵入性穿刺.
目的 探討孕早期利用頸項透明層厚度(NT),聯閤血清生化標誌物遊離β絨毛膜促性腺激素(Free-βhCG)、妊娠血漿相關蛋白A(PAPP-A)篩查DS敏感性.方法 收集2009年3月至2010年10月嘉興學院附屬婦幼保健院早孕建卡時自願參加產前篩查的孕婦(年齡17～45歲),共計11 882例.分彆于孕早期(11～13w+6d)測定孕婦血液中Free-βhCG、PAPP-A值,超聲測定NT值；對于同一箇體,利用風險計算軟件,比較在孕早期NT、Free-βhCG、PAPP-A聯閤篩查和血清學Free-βhCG、PAPP-A篩查對唐氏綜閤徵的檢齣率和特異性的異同,比較二種篩查方案的敏感性.結果 11 882例孕婦,共髮現18例DS,髮生率為0.15％.聯閤篩查和血清學篩查的檢齣率分彆為83.3％、72.2％,特異性為98.4％、97.3％,檢齣效率為7.18％、3.90％.受試者工作特徵麯線(ROC)麯線分析,孕早期聯閤篩查ROC麯線下的麵積值(AUC)為0.975(95％ CCI:0.943,1.007),血清學篩查AUC為0.901(95％ CI:0.789,1.013).結論 孕早期聯閤篩查比血清學篩查DS有比較高敏感性和特異性,在相同的假暘性率情況下有較高檢測率,可有效減少孕婦侵入性穿刺.
목적 탐토잉조기이용경항투명층후도(NT),연합혈청생화표지물유리β융모막촉성선격소(Free-βhCG)、임신혈장상관단백A(PAPP-A)사사DS민감성.방법 수집2009년3월지2010년10월가흥학원부속부유보건원조잉건잡시자원삼가산전사사적잉부(년령17～45세),공계11 882례.분별우잉조기(11～13w+6d)측정잉부혈액중Free-βhCG、PAPP-A치,초성측정NT치；대우동일개체,이용풍험계산연건,비교재잉조기NT、Free-βhCG、PAPP-A연합사사화혈청학Free-βhCG、PAPP-A사사대당씨종합정적검출솔화특이성적이동,비교이충사사방안적민감성.결과 11 882례잉부,공발현18례DS,발생솔위0.15％.연합사사화혈청학사사적검출솔분별위83.3％、72.2％,특이성위98.4％、97.3％,검출효솔위7.18％、3.90％.수시자공작특정곡선(ROC)곡선분석,잉조기연합사사ROC곡선하적면적치(AUC)위0.975(95％ CCI:0.943,1.007),혈청학사사AUC위0.901(95％ CI:0.789,1.013).결론 잉조기연합사사비혈청학사사DS유비교고민감성화특이성,재상동적가양성솔정황하유교고검측솔,가유효감소잉부침입성천자.
Objective To explore the sensitivity of using NT,combined with serum biochemical markers (Free-βhCG,PAPP-A) for Down's Syndrome screening in early stage of pregnancy.Methods Collect pregnant women aged 17-45 years old voluntary antenatal screening in our hospital from March 2009to October 2010,a total of 11882 cases.Serum Free-βhCG and PAPP-A were measured NT value was determined by ultrasound at 11-13w+64 of gestation.Calculating combined screening (NT,Free-βhCG,PAPP-A),and serum integrated screening (Free-beta hCG,PAPP-A) risk,respectively,using the risk calculation software for the same person.Results Early pregnancy screening was performed in 11 882patients,18 had a fetus with Down's syndrome,a rate of 0.15％.The detection rates of Down's syndrome in combined screening and serum integrated screening were 83.3％ and 72.2％ respectively.The specificities were 98.4％ and 97.3％ and detection efficiency were 7.18％,3.90％ respectively.Areas under the curve (AUCs) of fhst-trimester combined screening and serum integrated screening were 0.975 (95％ CI:0.943,1.007),0.901 (95％ CI:0.789,1.013) respectively.Conclusion In early stage of pregnancy,combined screening for Down's syndrome has higher sensitivity and specificity than serological screening,has higher detection rate in the same false-positive rate case,which can effectively reduce the pregnant women to receive invasive puncture.
