三种唐氏筛查方法的统计学评价  

Statistical evaluation on three tests for Down′s syndrome serum screening

作　　者：王华[1] 孙振球[2] 谢琼[1] 唐华[1] 贾政军[1] 谢冬华[1] 

机构地区：[1]湖南省妇幼保健院,长沙410008 [2]中南大学公共卫生学院,长沙410078

出　　处：《中国优生与遗传杂志》2012年第8期45-46,73,共3页Chinese Journal of Birth Health & Heredity

基　　金：湖南省科委课题(2009SK3048)

摘　　要：目的比较三种唐氏筛查方法的筛查效率。方法收集湖南省产前诊断中心数据,二联筛查方案为PAPPA+Freeβ-HCG,三联筛查方案为AFP+Freeβ-HCG+uE3,结合孕妇年龄、体重、孕周等因素运用软件计算风险率。对高风险孕妇进行羊水染色体检查及B超检查,每个孕妇随访追踪到胎儿出生。结果 <35岁组,孕早期筛查约登指数54.82%,曲线下面积(AUC)为0.774;孕中期二联筛查约登指数61.74%,曲线下面积(AUC)为0.809;孕中期三联筛查约登指数64.50%,曲线下面积(AUC)为0.822。≥35岁组,孕早期筛查约登指数39.13%,曲线下面积(AUC)为0.696;孕中期二联筛查约登指数41.01%,曲线下面积(AUC)为0.705;孕中期三联筛查约登指数55.58%,曲线下面积(AUC)为0.778。结论 <35岁组和≥35岁组中,孕中期三联筛查诊断价值高于孕中期二联筛查,孕中期二联筛查诊断价值高于孕早期二联筛查。Objeetive： To compare the efficiency of the three tests for Down＇s syndrome serum screening. Methods： collect samples from prenatal diagnostic center in Hunan provinee. The double test examined PAPPA ＋ Free β - HCG; the triple test examined AFP ＋ Free β - HCG ＋ uE3. Combining the age, weight, weeks of gestation to calculate the risk by software. To the high - risk pregnant women, check them with Amnioeentesis and B - ultrasound until the children were born. Result： in the team of younger than 35, youden index of test during first trimester of pregnancy is 54. 82%, Area under curve is 0. 774 ; youden index of double test during second trimester of pregnaney is 61.74%, Area under eurve is 0. 809 ; youden index of triple test during second trimester of pregnancy is 64. 50% , Area under eurve is 0. 822. In the team of older than 35, youden index of test during first trimester of pregnancy is 39. 13% , Area under curve is 0. 696; youden index of double test during seeond trimester of pregnancy is 41.04% , Area under curve is O. 705; youden index of triple test during second trimester of pregnancy is 55. 58% , Area under curve is 0. 778. Conelution： The effieieney of the triple test is higher than double test during seeond trimester of pregnaney and double test during second trimester of pregnancy is higher than double test during fisrt trimester of pregnancy whatever younger or older than 35.

关 键 词：唐氏综合征 产前筛查 约登指数 曲线下面积 

分 类 号：R714.55[医药卫生—妇产科学]