早孕期联合筛查预测唐氏综合征的效果分析  

Performance of first-trimester combined screening in the prediction of fetal Down's syndrome

作　　者：雷玲[1] 张媛[1] 

机构地区：[1]重庆市妇幼保健院母婴中心,重庆400010

出　　处：《重庆医科大学学报》2013年第10期1171-1173,共3页Journal of Chongqing Medical University

基　　金：重庆市卫生局资助项目(编号:2008-2-256)

摘　　要：目的:分析2010年3月-2011年12月我院早孕期联合筛查对唐氏综合征(Down’s syndrome,DS)的预测效果。方法:收集符合标准的研究对象共计7 367例,回顾性研究这些对象的妊娠结局,比较颈透明层厚度(nuchal translucency thickness,NT)单独使用及联合筛查预测DS的效果。联合筛查风险切割值取1∶300,对高危对象与低危对象的妊娠结局进行比较;以NT≥3 mm为筛查阳性标准,比较NT单独筛查及联合筛查,在预测效果上是否有差异。结果:7 367例筛查对象中,联合筛查阳性率为3.4%(252/7 367),实际染色体异常发生率为0.12%(9/252);高危组与低危组相比,高危组存在显著的不良妊娠结局高风险(不良妊娠结局6.0%vs.1.0‰,P<0.001,染色体异常3.6%vs.0.1‰,P<0.001);NT值作为单独指标时,DS检出率为77.8%,假阳性率为4.4%,而联合筛查时,DS检出率为88.9%,假阳性率为3.3%。结论:联合筛查能有效预测染色体异常且联合筛查的预测效果优于NT值作为单独指标的效果,应尽量推荐孕妇进行早孕期联合筛查。OBjective：To analyze the performance of first-trimester combined screening in the prediction of fetal Down＇s syndrome （DS）. Methods：Totally 7 367 cases met the criteria were collected and their pregnant outcomes were analyzed retrospectively. Pre- diction of DS when using nuchal translucency thickness （NT） alone was compared with that when using first-trimester combined screening. Risk cutoff value of first-trimester combined screening was set at 1：300 and pregnancy outcomes of high-risk and low-risk objects were compared. Performances of NT and first-trimester combined screening were compared taking NT I〉 3 mm as positive cri- teria. Results：Among the 7 367 cases,positive rate of first-trimester combined screening was 3.4%（252/7 367） and incidence of actu- al abnormal chromosomes was 0.12%（9/252）. High risk group had higher risk of adverse pregnancy outcomes compared with that of low risk group （adverse pregnancy outcomes：6.0% vs. 1.（~v~,P〈0.001 ;abnormal chromosomes ： 3.6% vs. 0.1%o,P〈0.001 ）. When using NT value as the only criterion, detection rate of DS was 77.8% and false positive rate was 4.4%;when using first-trimester combined screening, detection rate of DS was 88.9% and false positive rate was 3.3%. Conclusions：First-trimester combined screening can ef- fectively predict abnormal chromosomes and its effect is superior to that of NT alone,therefore,it is recommended for pregnant woman.

关 键 词：唐氏综合征 早孕期筛查 

分 类 号：R714.55[医药卫生—妇产科学]