摘要
目的分析孕中期孕妇血清甲胎蛋白(AFP)联合游离人绒毛膜促性腺激素β亚单位(freeβ-hCG)对胎儿染色体非整倍体的筛查效能。方法选取2014年1月至2018年12月丽水市妇幼保健院接收的84070例作产前筛查的孕中期孕妇作为研究对象。均检测血清AFP、freeβ-hCG水平,计算胎儿染色体非整倍体的高危切割值,对筛查高危孕妇进行羊水染色体核型检测;分析血清AFP联合freeβ-hCG对高风险的筛查结果,比较筛查高风险组与低风险组的胎儿染色体非整倍体确诊结果,观察血清AFP联合freeβ-hCG对胎儿染色体非整倍体的的筛查效能。结果不同筛查孕周孕妇AFP和freeβ-hCG MoM值中位数比较,差异均无统计学意义(均P>0.05);在84070例孕中期孕妇中,筛查21-三体、18-三体和其他非整倍体异常高风险孕妇的阳性率分别为3.73%、0.079%和0.045%;筛查高风险组与筛查低风险组21-三体、18-三体及其他非整倍体异常检出率比较,差异均具有统计学意义(均P<0.05);血清AFP联合freeβ-hCG筛查21-三体、18-三体及其他非整倍体异常的灵敏度分别为83.78%、85.29%和88.37%,特异度分别为96.25%、96.18%和96.19%。结论孕中期孕妇血清AFP联合freeβ-hCG筛查胎儿染色体非整倍体的效能较佳,获得理想的筛查结果,有助于提高羊水染色体核型的检测效率,值得临床推广应用。
Objective To analyze the screening effect of serum alpha-fetoprotein(AFP)combined with free human chorionic gonadotropinβsubunit(freeβ-hCG)on the fetal chromosome aneuploidy.Methods A total of 84070 pregnant women who were prenatally screened in Lishui Maternal and Child Health Hospital from January 2014 to December 2018 were selected as subjects.Their serum levels of AFP and freeβ-hCG were measured,to calculate high-risk cut values of fetal chromosome aneuploidy.Amniocentesis karyotype detection were performed for high-risk pregnant women,and high-risk screening results of serum AFP were analyzed combined with freeβ-hCG.The results of screening the fetal chromosome aneuploidy in the high-risk group and the low-risk group were com-pared,and the screening efficacy of serum AFP combined with freeβ-hCG on fetal chromosome aneuploidy was observed.Results There was no significant difference in the median AFP and freeβ-hCG MoM between pregnant women of different gestational weeks(P>0.05).Among the 84070 pregnant women in the second trimester,the positive rates of screening for 21-trisomy,18-trisomy and other atypical high risk pregnant women were 3.73%,0.079%and 0.045%respectively.There were statistically significant differences between the screening high-risk group and screening low-risk group in the detection rate of 21-trisomy,18-trisomy and other aneuploidy abnormali-ties(P<0.05).The sensitivity of serum AFP combined with freeβ-hCG screening for 21-trisomy,18-trisomy and other aneuploidy abnormalities was 83.78%,85.29%and 88.37%,and the specificities were 96.25%,96.18%and 96.19%accordingly.Conclusions In the second trimester,serum AFP combined with freeβ-hCG screening for fetal chromosome aneuploidy is better,and the ideal screening results are helpful to improve the detection efficiency of amniotic fluid karyotype,which is worthy of clinical application.
作者
蓝小芳
谢妙妙
舒静
杨慕枫
陈建虹
LAN Xiaofang;XIE Miaomiao;SHU Jing;YANG Mufeng;CHEN Jianhong(Department of Maternity and Health Care,Lishui Maternal and Child Health Hospital,Lishui 323000,Zhejiang,China;Prenatal Diagnosis Center,Lishui Maternal and Child Health Hospital,Lishui 323000,Zhejiang,China)
出处
《中国性科学》
2020年第9期86-90,共5页
Chinese Journal of Human Sexuality
关键词
胎儿染色体非整倍体
孕中期
甲胎蛋白
游离人绒毛膜促性腺激素β亚单位
筛查
Fetal chromosome aneuploidy
Second trimester
Alpha-fetoprotein(AFP)
Free human chorionic gonadotropinβsubunit(freeβ-hCG)
Screening
