摘要
目的分析近5年潮州地区妊娠中期血清学二联产前筛查数据和妊娠结局,探讨血清学产前筛查在潮州地区的临床应用价值。方法采用时间分辨免疫荧光检测仪对妊娠中期孕妇的血清进行AFP-HCG二联筛查,通过2T-Risks软件评估胎儿患21-三体综合征、神经管缺陷(Neural Tube Defects,NTD)、18-三体综合征三种缺陷的风险率。对筛查结果高风险的孕妇,建议其进行羊水或脐带血染色体核型分析或四维彩色多普勒超声检查等方法进一步诊断。结果分析了10 668例妊娠中期产前筛查结果,高风险677例,阳性率6.35%;其中21-三体综合征高风险501例、NTD高风险104例、18-三体综合征高风险72例,分别占筛查总数的4.70%、0.97%、0.67%。677例高风险孕妇随访结果:有356例进行产前诊断,结果发现21-三体综合征2例、其他染色体核型异常2例、NTD 3例、畸形4例、自然流产及死胎19例、其他异常10例,共40例,异常率5.91%。9 991例筛查低风险孕妇随访结果,发现21-三体综合征1例、NTD 2例、畸形3例、自然流产及死胎23例、其他异常28例,共57例,异常率0.57%。结论妊娠中期血清学产前筛查对预测异常胎儿、预防出生缺陷有重要的临床意义。
Objective To evaluate the clinical value of prenatal screening by analyzing the second - trimes- ter maternal serum screening results and prognosis. Methods The second - trimester maternal serum screening in- eluding alpha- fetoprotein （AFP） and β- human chorionic gonadotrophin （β -HCG） was tested by time -resolu- tion immunofluorescence. 2T - Risks software was used to evaluate fetal risk of three kinds of defects, such as trisomy 21, trisomy 18 and neural tube defects （NTD）. For those of pregnant women with high -risk screening results, am- niotie fluid, umbilical cord blood karyotype analysis or four - dimensional color Doppler ultrasound scan can be rec- ommended to confirm the diagnosis. Results This research included the analysis of 10 668 cases of pregnant meta- phase prenatal screening results. 677 cases were in high - risk, which took up 6.35%. Among those 677 cases, 501 cases had high -risk 21 -trisomy Syndrome, and 104 cases had high -risk NTD. 72 cases with high -risk 18 -tri- somy Syndrome had been found, and the percentage of those cases above were 4.70%, 0. 97% and 0.67%, respec- tively. As for the 677 follow - up pregnant women with high risks, the results indicated that during those 356 high - risk women, who had performed prenatal diagnosis, 2 cases of 21 - trisomy Syndrome, 3 cases of NTD, and 4 cases of structural abnormalities had been found. In addition, there were 19 cases of spontaneous abortion and stillbirth, as well as 10 cases of other abnormalities. There are 40 abnormal cases in total, which took up an abnormal percentage of 5.91%. In those 9 991 follow - up pregnant women with low risks, there are 57 eases （0.57%） presented abnor- mal, in which had 1 cases with 21 - trisomy Syndrome, 2 eases with NTD, 3 cases with deformity, 23 cases of spon- taneous abortion and stillbirth and 28 other abnormal cases. Conclusion The second - trimester maternal serum screening plays an important clinical role in the prediction of abnormal fetus and prevention of birth defects.
出处
《现代医院》
2015年第6期81-82,85,共3页
Modern Hospitals
