南方医科大学学报
南方醫科大學學報
남방의과대학학보
JOURNAL OF SOUTHERN MEDICAL UNIVERSITY
2010年
3期
532-534,537
,共4页
孕中期%唐氏筛查%染色体病%羊水细胞
孕中期%唐氏篩查%染色體病%羊水細胞
잉중기%당씨사사%염색체병%양수세포
middle period pregnancy%Down syndrome screening%chromosomal diseases%amniotic fluid cells
目的 探讨孕中期母血唐氏筛查及异常妊娠的临床价值.方法 采集孕中期(16～20周)母血,以美国Zymed"孕中期唐氏综合征产前筛查试剂盒"检测血清AFP和β-HCG,结合母龄、孕周、体质量等,采用软件综合计算胎儿染色体病的发病风险.对高风险孕妇行羊水细胞或脐带血细胞核型分析以确诊,并跟踪到胎儿出生.同时,将孕妇分为≥35和<35周岁组,唐氏阳性和阴性组,分别对其筛查结果和不良妊娠进行分析.结果共筛查6000例,552例阳性,漏检1例,阳性率约9.2%,接受羊水或脐带血穿刺者463例(84%),胎儿有染色体异常者共27例,建议终止妊娠者14例,其余13例为染色体多态性变异.≥35和< 35周岁两组孕妇筛查阳性率分别是95.5%和8.2 %(P<0.0001),其胎儿染色体异常率分别是4.5%和2.9%(P<0.5);筛查阳性和阴性两组中妊娠不良结局发生率分别为5.6%和0.05 %(P<0.0001),妊娠并发症发生率分别率分别为11.8%和3.7%(P<0.0001),胎儿染色体多态性发生率分别为2.8%和1.1%(P<0.5).结论 孕中期血清AFP和β-HCG联合检测,对于预测胎儿染色体病具有重要临床价值,可有效降低染色体病患儿的出生率,并对预防不良妊娠和妊娠并发症的发生具有一定应用价值.
目的 探討孕中期母血唐氏篩查及異常妊娠的臨床價值.方法 採集孕中期(16～20週)母血,以美國Zymed"孕中期唐氏綜閤徵產前篩查試劑盒"檢測血清AFP和β-HCG,結閤母齡、孕週、體質量等,採用軟件綜閤計算胎兒染色體病的髮病風險.對高風險孕婦行羊水細胞或臍帶血細胞覈型分析以確診,併跟蹤到胎兒齣生.同時,將孕婦分為≥35和<35週歲組,唐氏暘性和陰性組,分彆對其篩查結果和不良妊娠進行分析.結果共篩查6000例,552例暘性,漏檢1例,暘性率約9.2%,接受羊水或臍帶血穿刺者463例(84%),胎兒有染色體異常者共27例,建議終止妊娠者14例,其餘13例為染色體多態性變異.≥35和< 35週歲兩組孕婦篩查暘性率分彆是95.5%和8.2 %(P<0.0001),其胎兒染色體異常率分彆是4.5%和2.9%(P<0.5);篩查暘性和陰性兩組中妊娠不良結跼髮生率分彆為5.6%和0.05 %(P<0.0001),妊娠併髮癥髮生率分彆率分彆為11.8%和3.7%(P<0.0001),胎兒染色體多態性髮生率分彆為2.8%和1.1%(P<0.5).結論 孕中期血清AFP和β-HCG聯閤檢測,對于預測胎兒染色體病具有重要臨床價值,可有效降低染色體病患兒的齣生率,併對預防不良妊娠和妊娠併髮癥的髮生具有一定應用價值.
목적 탐토잉중기모혈당씨사사급이상임신적림상개치.방법 채집잉중기(16～20주)모혈,이미국Zymed"잉중기당씨종합정산전사사시제합"검측혈청AFP화β-HCG,결합모령、잉주、체질량등,채용연건종합계산태인염색체병적발병풍험.대고풍험잉부행양수세포혹제대혈세포핵형분석이학진,병근종도태인출생.동시,장잉부분위≥35화<35주세조,당씨양성화음성조,분별대기사사결과화불량임신진행분석.결과공사사6000례,552례양성,루검1례,양성솔약9.2%,접수양수혹제대혈천자자463례(84%),태인유염색체이상자공27례,건의종지임신자14례,기여13례위염색체다태성변이.≥35화< 35주세량조잉부사사양성솔분별시95.5%화8.2 %(P<0.0001),기태인염색체이상솔분별시4.5%화2.9%(P<0.5);사사양성화음성량조중임신불량결국발생솔분별위5.6%화0.05 %(P<0.0001),임신병발증발생솔분별솔분별위11.8%화3.7%(P<0.0001),태인염색체다태성발생솔분별위2.8%화1.1%(P<0.5).결론 잉중기혈청AFP화β-HCG연합검측,대우예측태인염색체병구유중요림상개치,가유효강저염색체병환인적출생솔,병대예방불량임신화임신병발증적발생구유일정응용개치.
Objective To study the clinical value of screening chromosomal diseases and abnormal pregnancy by maternal serum examination in mid-pregnancy. Methods Maternal serum AFP and F-β hCG were detected in the mid-pregnancy (16-20 weeks) using commercially available detection kits, and the risk of Down syndrome was calculated taking into account of such factors as the maternal age, gestational age, and body weight. Those at high risk underwent amino fluid or cordocentesis for fetal karyotpying. The pregnant women were divided into ≥ 35 years and <35 years groups, and high and low risk for Down syndrome groups for test results and pregnancy outeome analysis. Results Of the 6000 pregnant women undergoing antenatal screening, 552 were identified to be at high risk of Down syndrome (9.2%) with one missing case of detection, and 463 of the high-risk cases underwent amino fluid or cordocentesis examination. Twenty-seven cases were found to have abnormal chromosomes, and abortion was suggested in 14 cases but not in the other 13 cases where other chromosomal abnormalities such as polymorphic mutations were found. The screening positive rate in ≥35 years and <35 years group was 95.5% and 8.2% (P<0.0001), with fetal chromosomal abnormality rate of 4.5% and 2.9%, respectively (P>0.5). The rate of abnormal pregnant outcomes for high and low risk groups was 5.6% and 0.05% (P<0.0001), with pregnancy complication rate of 11.8% and 3.7% (P<0.0001) and fetal chromosomal polymorphic mutation rate of 2.8% and 1.1% (P>0.5), respectively. Conclusion Maternal serum AFP and F-βhCG levels in second trimester have important values in predicting fetal chromosomal diseases,and their detection may help reduce the birth defect rate and prevent abnormal pregnancy outcomes and complications.
