孕中期母体血清标志物筛查唐氏综合征价值探讨  

Serum maker for Down's syndrome screening at the metaphase of pregnancy

作　　者：高玮[1] 李俊华[1] 王倩[1] 张秀峰[1] 谢卫芳[1] 

机构地区：[1]广东省深圳市南山区计划生育服务中心,518052

出　　处：《蚌埠医学院学报》2010年第5期510-512,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨孕中期母体血清标志物对筛查唐氏综合征(Down′s Syndrome,DS)胎儿的临床意义。方法:采用时间分辨免疫荧光法检测孕中期妇女血清甲胎蛋白(AFP)和游离人绒毛膜促性腺激素β亚单位(β-hCG)浓度,再根据孕妇年龄、孕周、体重等因素,通过国产DS筛查软件输出中位数值倍数(MOM)计算风险概率。结果:3117例孕中期妇女接受筛查,其中高危177例,高危率5.68%,比用进口软件算出的高危率低。177例高危中有82例接受羊水穿刺细胞学检查,3例确诊DS,95例未接受羊水穿刺细胞学检查,有2例未足月就自发流产;筛查阴性的孕妇中皆没有DS患儿出生。≥35岁的孕妇组异常发生率高于35岁以下孕妇组,差异有统计学意义(P<0.01)。结论:孕中期母血清中检测AFP和游离β-hCG二联指标,采用国产DS软件进行风险评估,是目前较为可行、容易被孕妇接受的产前筛查技术。国产软件输出的MOM更适合中国人群,对于降低筛查假阳性率、减少医疗资源浪费有重要作用。Objective：To explore the clinical significance of serum marker at the metaphase of pregnancy in screening fetus Down＇s syndrome（DS）.Methods：The concentration of alpha-fetoprotein（AFP）and free β-subunit of human chorionic gonadotrophin（β-hCG）in the serum of women at the metaphase of pregnancy were tested by time-resolved fluoroimmunoassay.Multiples of the median（MOM）and the risk probability were calculated concerning the age,gestation and weight of the women by homemade DS screening software.Results：Three thousand and one hundred and seventeen women at the metaphase of pregnancy were screened;177 of them were in high risk of DS,and the high-risk rate was 5.68%,which was lower than that calculated by imported analysis software.Eighty-two of the 177 high risk cases received chromosome test by amniotic fluid puncturation and 3 cases were confirmed.Two of the remaining 95 cases which failed to take amniotic fluid test resulted in spontaneous abortion,and no DS newborns were delivered in women with negative screening results.The group over the age of 35 had a higher positive rate than that below 35.The difference was significant（P〈0.01）.Conclusions：The double-marker test with AFP and free β-hCG in serum of women at the metaphase of pregnancy using homemade analysis software is a feasible prenatal screening technology easily accepted by pregnant women.The MOM output by homemade software is more suitable to the Chinese,which may reduce the false positive rate of screening and diminish the waste of medical resources.

关 键 词：唐氏综合征 产前筛查 甲胎蛋白 人绒毛膜促性腺激素 

分 类 号：R714.53[医药卫生—妇产科学]