孕中期产前筛查母血清标志物中位数倍数的应用  

The applicability of multiple of median in second trimester maternal serum for prenatal screening

作　　者：蔡徐山[1] 戴清清 黄秋兰 陈怡[1] 陈宇[1] 齐结华[1] 王东江[1] 

机构地区：[1]上海市嘉定区妇幼保健院检验科,上海201800 [2]上海市嘉定区南翔医院检验科,上海201802

出　　处：《诊断学理论与实践》2009年第5期502-505,共4页Journal of Diagnostics Concepts & Practice

基　　金：上海市嘉定区卫生局青年基金(20061106)

摘　　要：目的:对嘉定地区孕中期孕妇甲胎蛋白(alpha fetoprotein,AFP)、人绒毛膜促性腺激素(β-human chorionic gonadotrophin,β-hCG)、游离雌三醇(unconjugated estriol,uE3)的中位数倍数(MoM)筛查结果进行回顾性分析,探讨在筛查可能孕唐氏综合征等患儿的孕妇时校正上述血清指标MoM的必要性。方法:选取1298例孕妇(孕周为15～21周)构建血清AFP、β-hCG、uE3中位水平与孕周间的回归关系,得到指标中位浓度,并对MoM值与体重的关系运用倒数模型回归得到体重校正后的MoM值。结果:结果显示孕周与3个血清指标水平的MoM值间无相关性(AFP:r=-0.045,P=0.102;β-hCG:r=-0.006,P=0.821;uE3:r=-0.042,P=0.132)。在未经体重校正的条件下,嘉定地区孕中期孕妇的AFP中位水平比软件内嵌的AFP参考值水平要低16.4%,β-hCG要高14.1%,uE3要高6.3%;软件计算的AFP MoM值中位数为0.78,β-hCG的MoM值中位数为1.02,uE3的MoM值中位数为1.03。经体重校正后的血清AFP、β-hCG、uE3的MoM值中位数分别为0.99、0.98和0.98,其中AFP、uE3的MoM值中位数在体重校正前、后的差异有统计学意义(P均<0.05)。结论:嘉定地区孕中期妇女的血清AFP、β-hCG、uE3中位水平与应用软件内嵌初始参数有显著差异,实验室在进行产前筛查时应建立适合于本室的产前筛查指标水平。Objective To study the necessity of adjusting the multiple of median （MoM） of alpha fetoprotein （AFP）, human chorionic gonadotropin β （β-hCG）and unconjugated estriol （uE3） in screening the second trimester of pregnancy for Down syndrome or other birth disfigurements in Jiading region. Methods The gestational age-specific median of maternal serum markers AFP, β-hCG and uE3 were calculated by means of regression method in 1298 pregnant women. Regression functions for adjustment of MoM by weight were established. Results There was no con＇elation between pregnant week and MoMs of markers mentioned above. Before the adjustment by weight, the median level of AFP was 16.4% lower, β-hCG was 14.1% higher and uE3 was 6.3% higher than those of Caucasian provided by the TCSofl software respectively. The MoM median calculated by the software were 0.78 for AFP, 1.02 for β-hCG and 1.03 for uE3, but when the AFP, β-hCG and uE3 MoM levels were converted to weight-adjusted levels, the MoM median were 0.99 （P〈 0.05）, 0.98 and 0.98 （P〈0.05）. Conclusions There is a difference of median weight-adjusted MoM levels between the data obtained from the pregnant women in the Jiading district and from TCSoft software （designed by Shanghai Tengcheng Medical Tech-info Co., Ltd）, therefore the screening laboratory should establish their own suitable criteria level.

关 键 词：唐氏综合征 产前筛查 中位数倍数 甲胎蛋白 人绒毛膜促性腺激素 游离雌三醇 

分 类 号：R714.55[医药卫生—妇产科学]