NT联合F-βhCG及PAPP-A在妊娠早期唐氏综合征诊断中的临床研究  

Clinical study of first trimester combined screening for Down's syndrome with NT,F-βhCG and PAPP-A

作　　者：程霞[1] 

机构地区：[1]安丘市人民医院母婴保健科,山东安丘262100

出　　处：《中国实验诊断学》2013年第9期1663-1665,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨分析NT联合F-βhCG及PAPP-A在妊娠早期唐氏综合征(Down’s syndrome,DS)诊断中的应用价值。方法取2008年4月-2012年12月于我院进行产前检查的5574例孕妇,测定所有孕妇血清F-βhCG与PAPP-A的水平,并采用超声检测胎儿的NT值,比较血清学检查与血清学检查联合NT测定对唐氏综合征早期评估的准确性。结果共10例患者被确诊为DS,血清学检查联合NT测定诊断DS的ROC曲线下面积要大于单一的血清学检查(0.963vs 0.897);DS组与非DS组平均年龄、F-βhCG、PAPP-A及NT的测定中位数值的差异比较有统计学意义(P<0.05);非条件多因素Logistic回归分析结果显示随着孕妇年龄(β=1.364,OR=3.912)、F-βhCG水平(β=1.294,OR=3.647)及NT水平(β=1.408,OR=0.488)的升高,胎儿患DS的风险增加,而随着PAPP-A水平(β=-1.117,OR=0.327)的升高,胎儿患DS的风险降低。结论 NT联合F-βhCG及PAPP-A在妊娠早期唐氏综合征诊断中的准确性较高,值得推广。Objective To study the application value of first trimester combined screening for Down＇s syndrome with NT,F-βhCG and PAPP-A. Methods Collect pregnant women who accept early pregnancy screening in our hospi- tal from April,2008 - December,2012. NT and serum level of F-βhCG and PAPP-A of all the cases were measured. Compare the accuracy of combined screening （NT, F-βhCG and PAPP-A） and serum integrated screening （F-βhCG and PAPP-A）. Results 10 cases were diagnosed with Down＇s syndrome,ROC areas of combined screening was larger than that of the serum integrated screening（0. 963 vs 0. 897）. Difference of age,serum level of F-βhCG and PAPP-A,NT between the DS group and non-DS group was statistically significant （P〈0.05）. When stepwise multiple logistic regression analysis was employed, age of the pregnant women （β= 1.364, OR= 3.912）, serum level of F-βhCG （β= 1. 294, OR = 3. 647） and NT （β= 1. 408, OR= 0. 488） were dependent predictors of the occurrence of DS while serum level of PAPP-A （β=-1. 117,OR=0. 327） was the protective factors from the occurrence of DS. Conclusion combined screening of NT,F-βhCG and PAPP-A has a high accuracy in diagnosis of DS,whieh is worth promoting.

关 键 词：颈项透明带厚度 游离β绒毛膜促性腺激素 妊娠血浆相关蛋白A 唐氏综合征 

分 类 号：R714.2[医药卫生—妇产科学]