血清标志物及年龄筛查与羊水染色体的相关性  

Correlation between amniotic fluid chromosome examination and serum marker and age screening

作　　者：段利利[1] 王林[1] 吝蓓蕾 陈必良[1] 张建芳[1] 白洁[1] 郝毅[1] 武晓凤[1] 

机构地区：[1]第四军医大学西京医院妇产科,陕西西安710032

出　　处：《中国妇幼健康研究》2015年第6期1133-1135,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的通过孕中期母血清标志物和孕妇年龄的产前筛查与羊水染色体检查阳性率的统计学处理,分析两者之间存在的相关性。方法选取2010年1月到2015年1期间在第四军医大学西京医院产检通过时间分辨免疫荧光法检测孕妇血清中甲胎蛋白(AFP)、游离雌三醇(E_3)以及促绒毛膜性腺激素(hCG)浓度筛查的唐氏综合征高危孕妇1 684例、爱德华综合征156例以及年龄35岁以上高危孕妇889例作为研究对象,行羊水穿刺,核型分析羊水染色体。结果在2 729例高危孕妇中有1 648例进行了羊水穿刺,穿刺率为60.39%。唐氏综合征根据分母依次递增分为4个等级,N≥1/100的产前诊断阳性率为5.88%,高于其他风险等级,等级间比较有显著性差异(x^2=4.24,P<0.05)。爱德华综合征根据分母依次递增分为7个等级,N≥1/50的阳性率为15.79%,高于其他风险等级,等级间比较有显著性差异(x^2=32.75,P<0.05)。对1 648例行羊水穿刺的患者根据年龄判断产前诊断阳性检出率,结果表明35岁及以上年龄患者产前阳性诊断率高于小于35岁的患者,年龄段之间比较有显著性差异(x^2=4.25,P<0.05)。结论孕中期母血清标志物的产前筛查与羊水染色体检查对于降低唐氏综合征有重要意义,但如何提高产前筛查效果,降低出生缺陷率,还需根据患者的临床症状及相关检查进行综合判断。Objective To analyze the correlation between amniotic fluid chromosome and maternal serum markers by statistical process of maternal serum markers, maternal age screening and chromosome positive rate of amniotic fluid. Methods From January 2010 to January 2015 1 684 Down＇ s syndrome women, 156 Edward syndrome women and 889 high-risk （ 〉 35 years old） pregnant women were selected as objective from Xijing Hospital of Fourth Military Medical University, whose maternal serum AFP, E3 and hCG concentrations were examined by time-resolved immune fluorescence assay. Amniocentesis and amniotic fluid karyotype analysis were done. Results Totally 1 648 of 2 729 high-risk pregnant cases underwent amniocentesis, and the ratio was 60.39%. Down＇ s syndrome was divided into four grades according to the denominator, and positive rate of N ≥ 1/100 in prenatal diagnosis was 5.88% , which was higher than other risk grades. The differences among grades were significant （X2 = 4.24, P 〈 0.05 ）. Edward syndrome was divided into seven grades, and positive rate of N I〉 1/50 in prenatal diagnosis was 15.79% , which was higher than other risk grades. The differences among grades were significant （X2 = 32.75, P 〈 0.05）. Prenatal diagnostic positive rate was judged according to maternal age among 1 648 cases undergoing amniocentesis. The results showed that prenatal diagnostic positive rate of cases aged 35 or over was higher than that of those below 35, and the difference among different age group was significant （X2 = 4.25,P 〈 0.05 ）. Conclusion Prenatal maternal serum markers screening and amniotic fluid chromosome examination during mid-trimester are important to reduce the incidence of Down＇ s syndrome, but how to improve the effect of prenatal screening and reduce birth defect rate need comprehensive judgment according to patients＇ clinical symptoms and related examination.

关 键 词：血清标志物 产前筛查 产前诊断 羊水穿刺 唐氏综合征 

分 类 号：R446[医药卫生—诊断学]