妊娠孕中期唐氏筛查结果分析  

Results of the second trimester of pregnancy screening for Down

作　　者：柯汝淑 陈雪华 赵小红 陈雅 

机构地区：[1]浙江省瑞安市妇幼保健院妇产科,浙江瑞安325200

出　　处：《中国医药导报》2015年第4期91-94,共4页China Medical Herald

基　　金：浙江省瑞安市科技计划项目(编号201302021);浙江省温州市科技计划项目(编号Y20130123)

摘　　要：目的 分析妊娠孕中期唐氏筛查结果.方法 选择2012年10月1日～2013年9月30日瑞安市妇幼保健院7076例孕15～20周孕妇为研究对象,采用时间分辨荧光分析法对其进行血清甲胎蛋白（AFP）以及游离绒毛膜促性腺激素（F-βHCG）的定量检测.再根据孕妇年龄、体重、孕龄等因素通过唐氏筛查软件算出唐氏风险系数,以阳性切割值1/270为高危.并对高风险的孕妇进行B超跟踪检查、羊水胎儿细胞染色体核型分析、羊水穿刺.分析7076例孕妇中唐氏高风险孕妇高风险类型分布、高风险孕妇筛查结果、不同孕龄段筛查结果.结果 7076例孕妇中唐氏高风险者396例,阳性率为5.6％.在对孕妇进行羊水胎儿细胞染色体核型分析的结果中显示,276例唐氏综合征（DS）高风险孕妇中,共有唐氏胎儿4例,死胎3例,其他异常3例.对57例伴有神经管缺陷的高危孕妇进行B超检查结果显示,1例无脑儿.对43例18-三体高危孕妇中的6例孕妇做羊水染色体检查,结果显示均为正常.296例DS高风险孕妇中,孕15～15＋6周的检出率为50％,孕16～16＋6周的检出率为100％,孕17～17＋6周的检出率为100％,孕18～18＋6周的检出率为100％,孕19～20周的检出率为0％,孕16～18＋6周的检出率（100％）显著优于孕15～15＋6周及19～20周,差异均有统计学意义（均P＜0.05）.孕16～18＋6周高风险率（3.70％）及假阳性率（3.65％）明显低于孕15～15＋6周（6.78％、6.64％）及19～20周（6.78％、5.70％）,差异均有统计学意义（均P＜0.05）.结论 孕中期产前血清筛查是降低DS的重要手段,特别对胎儿染色体异常进行筛查是有效的方法,并对筛查结果为高危的孕妇进行B超检查或者羊水染色体核型分析能大大降低胎儿出生后的缺陷率.Objective To analyze the pregnancy trimester Down＇s screening results. Methods 7076 cases of 15-20 weeks of gestation in pregnant women from October 1, 2012 to September 30, 2013 in Maternity and Child Care Centers of Rui′an City were selected as study objects, the serum alpha-protein（AFP） and free human choice namedropping hormones（F-βHCG） of them were quantitative detected by time-resolved fluoroisnmunoassay, according to maternal age, body weight, gestational age and other factors by Down screening software, the risk factor to the positive value of1/270 for cutting high-risk was calculated. And high-risk pregnant women for B-track inspection, amniotic fluid prototype analysis of fetal cells, amniocentesis. The distribution of high-risk types of high-risk pregnant women, screening results in high-risk pregnant women, gestational age segments of different screening results of 7076 pregnant women were analyzed. Results 7076 cases in 396 cases of pregnant women at high risk of Down, the positive rate of 5.6%. In the result of fetal cells in the amniotic fluid of pregnant women prototype analysis showed that 276 cases of 21-three body syndrome high-risk pregnant women, there were 4 cases of Down fetuses, stillbirths 3 cases, 3 cases of other abnormalities. 57 cases of neural tube defects associated with high-risk pregnancies B-test results showed that one case of encephalitic children. 43 cases of pregnant women in high-risk of 18-three body syndrome all did chromosome examination showed normal. In the screening of Down fetuses, in 296 cases of high risk for Down, gestation detection rate of 15-15＋6weeks was 50%; 16-16＋6weeks was 100%; 17-17＋6weeks was 100%; 18-18＋6weeks was 100%; 19 to 20 weeks was 0%. the gestation detection rate of 16-18＋6weeks（100%） was significantly better than those of the 15-15＋6weeks and 19-20 weeks, the differences were statistically significant（all P 〈0.05）; risk rate（3.70%） and false positive rate（3.65%） of 16-18＋6weeks were significantly lowe

关 键 词：唐氏综合征 妊娠 孕中期 产前 血清筛查 

分 类 号：R714.55[医药卫生—妇产科学]