中华医学遗传学杂志
中華醫學遺傳學雜誌
중화의학유전학잡지
CHINESE JOURNAL OF MEDICAL GENETICS
2011年
3期
332-335
,共4页
俞冬熠%傅平%张战红%王芳%韩美艳%任慧颖%赵炜%张凯%李朔%姜楠
俞鼕熠%傅平%張戰紅%王芳%韓美豔%任慧穎%趙煒%張凱%李朔%薑楠
유동습%부평%장전홍%왕방%한미염%임혜영%조위%장개%리삭%강남
唐氏综合征%产前筛查%孕中期%甲胎蛋白%游离β绒毛促性腺激素%游离雌三醇
唐氏綜閤徵%產前篩查%孕中期%甲胎蛋白%遊離β絨毛促性腺激素%遊離雌三醇
당씨종합정%산전사사%잉중기%갑태단백%유리β융모촉성선격소%유리자삼순
Down's syndrome%prenatal screening%second trimester pregnancy%alpha-fetoproteins%human chorionic gonadotrophin,beta subunit%unconjugated estriol
目的 对孕中期多种产前筛查方案进行比较、评价,为选择较为适宜的方案提供依据.方法 收集2009年在青岛市产前诊断中心知情同意接受产前筛查的单活胎妊娠30 547例,分别检测母血清中二联或三联血清标记物,均用Lifecycle软件评估胎儿罹患唐氏综合征的风险,对二者的检出率和成本效益进行比较、分析;同时收集64例唐氏综合征妊娠的血清标本,采用二联筛查(double test,DT)+2T-Risks软件计算风险(DT-2T),二联筛查+Lifecycle软件计算风险(DT-LC),三联筛查(triple test,TT)+2T-Risks软件计算风险(TT-2T)和三联筛查+ Lifecycle软件计算风险(TT-LC)4种不同的筛查方案对胎儿罹患唐氏综合征的风险进行评估,并对各种不同的筛查方案进行比较、评价.结果 (1)64例唐氏综合征妊娠的血清标本,采用Lifecycle软件进行风险评估,检出率均高于同样指标筛查而采用2T-Risks软件评估风险方案;三联筛查不适宜使用2T-Risks软件;(2)30 547例单活胎妊娠的筛查中,DT-LC方案和TT-LC方案对于唐氏综合征的检出率分别为56.25%和57.14%;每检出1例唐氏综合征的平均费用DT-LC方案明显低于TT-LC方案,为优选方案.结论 孕中期DT-LC方案是一种利于在全国广泛开展的、经济有效的筛查方案.
目的 對孕中期多種產前篩查方案進行比較、評價,為選擇較為適宜的方案提供依據.方法 收集2009年在青島市產前診斷中心知情同意接受產前篩查的單活胎妊娠30 547例,分彆檢測母血清中二聯或三聯血清標記物,均用Lifecycle軟件評估胎兒罹患唐氏綜閤徵的風險,對二者的檢齣率和成本效益進行比較、分析;同時收集64例唐氏綜閤徵妊娠的血清標本,採用二聯篩查(double test,DT)+2T-Risks軟件計算風險(DT-2T),二聯篩查+Lifecycle軟件計算風險(DT-LC),三聯篩查(triple test,TT)+2T-Risks軟件計算風險(TT-2T)和三聯篩查+ Lifecycle軟件計算風險(TT-LC)4種不同的篩查方案對胎兒罹患唐氏綜閤徵的風險進行評估,併對各種不同的篩查方案進行比較、評價.結果 (1)64例唐氏綜閤徵妊娠的血清標本,採用Lifecycle軟件進行風險評估,檢齣率均高于同樣指標篩查而採用2T-Risks軟件評估風險方案;三聯篩查不適宜使用2T-Risks軟件;(2)30 547例單活胎妊娠的篩查中,DT-LC方案和TT-LC方案對于唐氏綜閤徵的檢齣率分彆為56.25%和57.14%;每檢齣1例唐氏綜閤徵的平均費用DT-LC方案明顯低于TT-LC方案,為優選方案.結論 孕中期DT-LC方案是一種利于在全國廣汎開展的、經濟有效的篩查方案.
목적 대잉중기다충산전사사방안진행비교、평개,위선택교위괄의적방안제공의거.방법 수집2009년재청도시산전진단중심지정동의접수산전사사적단활태임신30 547례,분별검측모혈청중이련혹삼련혈청표기물,균용Lifecycle연건평고태인리환당씨종합정적풍험,대이자적검출솔화성본효익진행비교、분석;동시수집64례당씨종합정임신적혈청표본,채용이련사사(double test,DT)+2T-Risks연건계산풍험(DT-2T),이련사사+Lifecycle연건계산풍험(DT-LC),삼련사사(triple test,TT)+2T-Risks연건계산풍험(TT-2T)화삼련사사+ Lifecycle연건계산풍험(TT-LC)4충불동적사사방안대태인리환당씨종합정적풍험진행평고,병대각충불동적사사방안진행비교、평개.결과 (1)64례당씨종합정임신적혈청표본,채용Lifecycle연건진행풍험평고,검출솔균고우동양지표사사이채용2T-Risks연건평고풍험방안;삼련사사불괄의사용2T-Risks연건;(2)30 547례단활태임신적사사중,DT-LC방안화TT-LC방안대우당씨종합정적검출솔분별위56.25%화57.14%;매검출1례당씨종합정적평균비용DT-LC방안명현저우TT-LC방안,위우선방안.결론 잉중기DT-LC방안시일충리우재전국엄범개전적、경제유효적사사방안.
Objective To provide basis for selecting the suitable method of Down's syndrome biochemical screening in the second trimester pregnancy. Methods A total of 30 547 singleton pregnancies between 14 and 20+6 weeks of pregnancy were collected and analyzed for maternal serum alpha-fetoproteins (AFP) and human chorionic gonadotrophin,free beta subunit (β-HCG) with or without unconjugated estriol (uE3). The screening risks were calculated using the software Lifecycle. The detection rates and the cost of per Down's syndrome detected were calculated and compared. And four different methods were compared in a series of 64 serum samples from Down's syndrome pregnancies. Results (1) Among the 64 affected cases, the detection rate of Down's syndrome was improved no matter in the double test (DT) or in the triple test (TT) if software Lifecycle (LC) was used to evaluate risks. And it was not suitable to evaluate risks with software 2T-Risks in the triple tests. (2) In the cohort of 30 547 singleton pregnancies, the detection rate of Down's syndrome with project DT-LC, which was double test using AFP and free β-HCG together with software Lifecycle, and project TT-LC, which was triple test using AFP, free β-HCG and uE3 together with software Lifecycle, was 56.25% and 57.14%, respectively. The former project was better because it decreased the false positive rate at a lower running cost. Conclusion The DT-LC is an effective screening strategy for second trimester detection of fetal Down's syndrome in mainland China.
