摘要
目的:建立基于杭州市萧山区孕妇的胎儿双顶径孕龄估算公式,并分析其运用于产前筛查的效果。方法:选取2012年1月至2015年4月在浙江萧山医院接受产前筛查的3500名孕妇为研究对象,孕龄控制在15周~19周+6。应用超声检查对3500名胎儿的双顶径进行测量,形成基于本地胎儿双顶径的孕龄拟合方程(本地公式)。应用此公式对2014年5月至2015年5月1759名月经不规则或者末次月经不详的孕妇进行产前筛查风险计算,并与LifeCycle 4.0软件内置公式所得的结果进行比较。结果:应用本地公式以后,唐氏综合征、18三体综合征和神经管畸形的总阳性率从6.96%降至5.85%(P<0.05)。其中,应用本地公式获得的唐氏综合征的筛查阳性率低于内置公式(P<0.05),神经管畸形的筛查阳性率高于内置公式(P<0.05),而两者18三体综合征的筛查阳性率差异无统计学意义(P>0.05)。内置公式与本地公式所得的游离β-人绒毛膜促性腺激素MoM中位数和甲胎蛋白MoM中位数比较差异有统计学意义(均P<0.05),其中本地公式所得的MoM中位数更接近1。所有确诊孕妇应用孕龄本地公式和内置公式筛查具有相同的疾病检出率。结论:基于本地区人群的胎儿双顶径估算孕龄可以降低产前筛查的假阳性率,使产前筛查的结果更加准确。
Objective： To establish a fetal biparietal diameter （BPD）-gestational age formula based on the data of pregnant women from Xiaoshan District of Hangzhou,and to evaluate its application in prenatal screening. Methods： Data of 3500 pregnant women with gestational age between 15 weeks and 19 weeks ＋ 6 receiving prenatal screening in Xiaoshan Hospital during May 2014 and May 2015 were collected. BPDs were used to establish a localized BPD-gestational age formula. The localized formula was used to evaluate the prenatal screening risks in 1759 pregnant women with irregular menstrual cycles or uncertain last menstrual period （LMP） in Xiaoshan District, and the results were compared with those calculated using formula in LifeCycle 4.0. Results： With localized formula, the total positive rate of Down syndrome, trisomy 18 syndrome and deformity of neural tube was decreased from 6.96% to 5.85% （ P 〈 0.05） , in which the positive rate of Down syndrome decreased （ P 〈 0. 05 ）, that of deformity of neural tube increased （P 〈 0. 05 ）, and that of trisomy 18 syndrome remained the same （P 〉 0.05）. The median MoMs of free-hCG β and α-fetoprotein calculated using localized formula were significantly different from those calculated using the formula in LifeCycle 4.0 （all P 〈 0.05 ） , and the former ones were more closer to 1. For women of fetus diagnosed with the above diseases, the positive rate calculated using localized formula was almost the same as that calculated using the formula in LifeCycle 4. 0. Conclusion： BPD-gestational age formula should be localized based on the statistical analysis of the local population, which will help to reduce the false positive rate, and make the results more accurate and reliable in prenatal screening.
出处
《浙江大学学报（医学版）》
CAS
CSCD
北大核心
2017年第1期59-65,共7页
Journal of Zhejiang University(Medical Sciences)
基金
杭州市萧山区重大科技攻关项目(2014216)
关键词
胚胎和胎儿发育
神经管缺损
超声检查
产前
孕龄
唐氏综合征
综合征
普查
Ultrasonography, Embryonic and fetal development
Neural prenatal
Gestational age
Down syndrome
Syndrome
tube defects
Mass screening
