孕中期Down′s综合征产前筛查的血清和血片方法的一致性研究  

Coherence study of second-trimester screening for Down syndrome in dried blood spots and sera.

作　　者：周玉侠[1,2] 张莉[3] 刘霞[1,2] 

机构地区：[1]山东省妇幼保健所 [2]山东大学附属省立医院,250014 [3]上海交通大学附属上海市儿童医院,200040

出　　处：《中国优生与遗传杂志》2010年第3期62-63,8,F0004,共4页Chinese Journal of Birth Health & Heredity

基　　金：2003年山东省医药卫生科研项目

摘　　要：目的验证血片方法与血清方法应用于孕中期Down′s综合征产前筛查的一致性。方法同时对1096例孕15-20孕周孕中期孕妇血清以及滤纸干血片中的AFP及β-hCG含量进行了检测,对血清以及滤纸干血片中两分析物的浓度、中倍数进行了相关性分析,比较了两种方法的筛查结果。结果血清与血片中AFP及β-hCG含量呈高度相关,相关系数分别为0.979、0.982。血清与血片中AFP及β-hCGMoM呈高度相关,相关系数为0.968、0.975。当筛查切值为1/270时,血片法和血清法筛查假阳性率分别为6.4%和5.6%。结论血片与血清中AFP及β-hCG含量呈高度相关,血片方法和血清方法应用于孕中期Down′s综合征产前筛查一致性好,血片法可以代替血清法应用于孕中期Down′s综合征产前筛查。Objective： To investigate the consistency between dried blood spots and fresh serum screening for Down＇s syndrome in the second trimester pregnancy. Methods： We collected the venous blood to prepare for two dried blood spots and fresh serum from 1096 singleton pregnant women in their second - trimester pregnancy. We detected the concentration level of AFP and β- hCG respectively in blood spots specimen and serum specimen, then the concentrations were reverted to MoM by divided the mediumin the same gestation week. The concentration and MoM in dried blood spots and in fresh serum were analysed for correlation, the risks of Down syndrome were determined through associate statistics software. We overview the outcome of risks for a single subject through dried blood specimen and conventional serum specimen, compare the results of and evaluate the concordance of this two methods for screening Down syndrome through screening positive rate, detection rate. Results： The correlation coefficient of AFP level between serum and dried blood specimen is 0. 979 and β- hCG is 0. 982. The correlation coefficient of AFP MoM between serum and dried blood specimen is 0. 968 and β- hCG MoM is 0. 975. The difference of screening results from the 1096 subjects using the two methods are not statistically significant. When screening positive cut - off is 1/270, the screening positive rate of dried blood spots versus fresh sera was 6. 4% vs. 5.6%. Conclusions ： Both β - hCG and AFP level between serum and dried blood specimen are perfect correlated. Screening results of dried blood spots for Down syndrome is concordance with that of serum, and dried blood spots can substitute fresh serum used for DS prenatal screening.

关 键 词：孕中期 Down’s综合征 筛查 

分 类 号：R714.55[医药卫生—妇产科学]