唐氏综合征产前筛查方案选择影响因素的敏感性分析  

Sensitivity Analysis of Influencing Factors of Prenatal Screening Scheme for Down's Syndrome

作　　者：谭晓冬[1] 王梅[2] 彭左旗[3] 马旭[3] 

机构地区：[1]湖南省人民医院,长沙410005 [2]卫生部卫生经济研究所,北京100083 [3]国家人口计生委科学技术研究所

出　　处：《中国计划生育学杂志》2007年第7期400-403,共4页Chinese Journal of Family Planning

基　　金：国家十重点科技攻关资助项目

摘　　要：目的:找出影响唐氏综合征产前筛查方案选择的主要因素。方法:运用决策分析(Treeage)软件,在两联筛查和三联筛查不同检出率与假阳性率成本效果分析的基础上,针对方案选择的主要影响因素进行敏感性分析。结果:发病率在0.5‰～2‰时,对两联筛查与三联筛查最佳方案的选择均没有影响;实验室筛查费用对酶联免疫法两联筛查、化学发光法三联筛查最佳方案的选择也无影响,但时间分辨法两联筛查的实验室费用在90～150元时,影响最佳方案的选择;产前诊断率在20%～100%时,对酶联免疫法两联筛查和化学发光法三联筛查最佳方案的选择并无影响;但对时间分辨法的最佳方案选择有一定影响。结论:降低筛查的实验室费用和提高产前诊断率,是增加产前筛查效益的主要手段。Objective： To probe into the main influencing factors of prenatal scheme for Down＇s syndrome. Methods： Based on the result of the cost - effectiveness analysis of double and triple test, Treeage software was used to implement a sensitivity analysis of influencing factors of prenatal scheme for Down＇s syndrome. Results ： The incidence rate which was between 0.5‰ and 2‰ had no influence on the selection of screening scheme. The cost of screening test showed no influence on the selection of screening scheme detected by double - test enzyme linkedimmunsorbsent assay （ELISA） and triple - test chemiluminesent immunoassay. When the cost of screening test is between 90 and 150 yuan, the selection of best scheme was influenced. Prenatal diagnosis rate showed no influence on the selection of screening scheme detected by double - test enzyme linkedimmunsorbsent assay（ELISA） and triple -test chemiluminesent immunoassay, however, influenced on the double -test time resolved fluoroisnmunoassay（TRFIA） to some extent. Conclusion： Influences which include the cost of screening test and prenatal diagnosis rate are showed on the selection of the best scheme for Down＇s syndrome detected by double - test time resolved fluoroisnmunoassay.

关 键 词：唐氏综合征 筛查 敏感性分析 

分 类 号：R714.5[医药卫生—妇产科学]