妊娠中期唐氏综合征血清学筛查与妊娠结局的研究  

Study on serological screening and pregnancy outcome od Down syndrome during mid-term pregnancy

作　　者：吴杰[1] 曾海燕[1] 

机构地区：[1]广东省梅州市人民医院检验科,514031

出　　处：《齐齐哈尔医学院学报》2015年第12期1723-1725,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨妊娠中期唐氏血清学筛查对胎儿染色体异常和不良妊娠结局的临床价值。方法2010年7月至2013年4月,采用全自动化学发光免疫分析法对我院2 386例妊娠中期（14~20＋6）妇女进行血清标志物游离雌三醇（u E3）、甲胎蛋白（AFP）和绒毛膜促性腺激素（β-h CG）的水平进行检测,结合孕妇年龄、孕周、体重等指标,采用Multicalc软件综合评定唐氏综合征风险;对高危孕妇在知情同意后进行羊水细胞染色体核型分析以确诊,并追踪胎儿和孕妇情况。结果产前筛查的2 386例孕妇中唐氏高危孕妇101例,阳性率为4.23%（101/2386）,其中89例接收羊水穿刺产前诊断,占筛查高危孕妇的88.11%（89/101）;发现胎儿染色体异常5例,其中21-三体综合征1例,18-三体综合征2例,神经管缺损高风险1例。唐氏筛查高、低风险组不良妊娠结局率分别为28.71%和7.61%,差异具有统计学意义（χ2=55.31,P〈0.05）。结论妊娠中期唐氏血清学筛查是预测不良妊娠结局和胎儿异常的有效手段之一,与羊水产前诊断联合对预防不良妊娠具有重要的临床应用价值。Objective To explore the clinical value of Down＇s Screening in the middle pregnancy to antenatal diagnosis and congenital birth defect.Methods Serum AFP, free-β-HCG and uE3 level of 2386 pregnant women （14~20 ＋6） from July 2010 to April 2013 in our hospital were detected by fully automatic chemiluminescence method.The value of serum markers combined with the maternal age, gestational age, weight and other index were conduct a comprehensive analysis by Multicalc software to calculate Down,s syndrome risk. For these high risk gravida, conduct fetal karyotype analysis and continue to track the fetal and maternal outcomes.Results There were 101 cases of high risk pregnant women of 2386 pregnant women and the positive rate is 4.23% （ 101/2386 ） .5 cases of fetal chromosome abnormalities in 89 pregnant women who received prenatal diagnosis of amniotic fluid.Among the 5 fetal chromosome abnormalities, there were 1 case of Down＆#39;s syndrome, 2 cases of 18-trisomy, 1 cases of Tumerˊs syndrome.The adverse pregnancy outcomes in the high risk and low risk group of Downˊs screening were 28.71% and 7.61%, showing significant difference（χ2 =55.31, P〈0.05）.Conclusions Down,s Screening in the middle pregnancy is an effective tool for predicting abnormal and adverse pregnancy outcomes.Combination of amniotic fluid prenatal diagnosis has an important clinical value for prevent adverse pregnancy.

关 键 词：妊娠中期 唐氏筛查 产前诊断 胎儿异常 

分 类 号：R714.251[医药卫生—妇产科学]