摘要
目的 探讨目前唐氏综合征（DS）孕中期母血清二联筛查（AFP,Free β- HCG）与三联筛查（AFP,Free β-HCG和μE3） 的临床有效性.方法 采用全自动时间分辨荧光免疫分析仪对妊娠14～20 w妇女进行血清游离雌三醇（μE3）、甲胎蛋白（AFP）、游离绒毛膜促性腺激素β亚基（Free β-HCG） 检测.分别用二联与三联方案分析计算胎儿发生唐氏综合征（Down syndrome,DS） 的危险概率并随访妊娠结局.结果 5 512例孕妇中,检出DS胎儿7例,漏诊1例,以1∶250作为阳性切割值时,DS三联和二联筛查的阳性率分别为8.74% （482/5 512）和3.90% （215/5 512）,差异有统计学意义 （χ2=117.6,P〈0.05）;检出的阳性率分别为0.91‰ （5/5 512）和1.09‰（6/5 512）,前者比后者低,差异有统计学意义（χ2=7.7,P〈0.05）.结论 孕中期应用母血清二联和三联方案进行产前筛查均可有效地减少出生缺陷的发生,但三联法的临床有效率更高.
Objective To investigate the clinical value of dual-marker （AFP,Free β-HCG） and triple-marker （AFP,Free-β-HCG and μE3） in prenatal screening on Down＇s syndrome during second trimester of pregnancy. Methods Serum levels of alpha fetoprotein （AFP） and the serum AFP,Free β-HCG and μE3 in 5 512 pregnant women were determined with time resolved fluorometric assay,then the results were analysed by risk software to determine the fetal risk of Down＇s syndrome （DS）. Results 5 512 pregnant women in second-trimester were screened and traced from January 2008 to March 2010. Of the cases studied, 7 fetuses with DS were detected and 1 case with DS was fail for screening. So the incidence rate of DS was 1.27‰ in the second-trimester of Wuhan city. When the risk of 1：250 as the cutoff to define a positive screening result of DS on the triple and the dual test,the FPR of the former（3.97%） was significantly lower than the latter （8. 74%）（P〈 0.05）. The positive rates of detection screened by the two methods were 0. 91‰ and 1.09‰,respectively,the former higher than the latter （P〈0. 05）. Conclusion The triple test instead of the daul test for second-trimester screening for DS can be more effective. It is positively significant and practical that reducing failure of detection for DS and avoiding wound prenatal diagnosis.
出处
《现代检验医学杂志》
CAS
2010年第4期49-51,54,共4页
Journal of Modern Laboratory Medicine
基金
本课题妾湖北省自然科学基金项目（2009CDB194）及武汉大学自主创新项目（3082022）资助.
关键词
唐氏综合征
产前筛查
二联法
三联法
antenatal screening
Down＇s syndrome
dual-marker
triple-marker
