9508例妊娠中期孕妇血清学筛查结果分析  

Analysis of Serological Screening Results of 9 508 Pregnant Women in the Second Trimester of Pregnancy

作　　者：杨晓[1] 郭嘉[1] 彭薇[1] 朱丽娜[1] 王艳[1] 

机构地区：[1]北京军区总医院附属八一儿童医院发育生物学实验室,100700

出　　处：《国际妇产科学杂志》2016年第1期35-38,共4页Journal of International Obstetrics and Gynecology

基　　金：国家自然科学基金(81300527)

摘　　要：目的：回顾性分析妊娠中期孕妇产前血清学筛查结果,探讨血清学筛查的重要意义。方法：检测2010年9月—2014年3月于北京军区总医院妇产科门诊产检的妊娠中期（15~20＋6周）9 508例孕妇血清中的甲胎蛋白（AFP）、人绒毛膜促性腺激素β亚单位（β-h CG）和游离雌三醇（u E3）的浓度并结合孕周、年龄、体质量等因素进行风险评估。结果：9 508例接受妊娠中期唐氏筛查的孕妇中,有743例孕妇筛查结果为高风险,筛查阳性率为7.81%。其中唐氏综合征（DS）高风险检出率为5.92%（563/9 508）,18-三体高风险检出率为0.20%（19/9 508）,开放性神经管缺陷（NTD）高风险检出率为1.69%（161/9 508）。羊水细胞染色体核型分析确诊DS 5例,18-三体1例,其他染色体异常共12例。本研究结果显示：20岁~组,25岁~组,30岁~组和≥35岁组间DS和NTD的高风险检出率差异均有统计学意义（P〈0.01）;年龄≥35岁高风险孕妇中DS阳性率明显高于年龄〈35岁高风险孕妇（P〈0.01）;对筛查低风险孕妇进行随访发现DS假阴性结果 1例。结论：产前血清学筛查对降低出生缺陷、提高人口素质有一定的指导意义。Objective：Retrospectively analyzed the serological screening results of pregnant women in their second trimester, to explore the significance of serological screening. Methods：The concentration of alpha-fetoprotein（AFP）,beta subunit of human chorionic gonadotropin（β-h CG） and unconjugated estriol（u E3） was detected in serum of 9 508 pregnant women（15-20＋6gestational weeks） in obstetrics and gynecology department of Beijing Military General Hospital from September 2010 to March 2014. Risks were assessed by combination with maternal age,gestational age and weight of pregnant women. Results：Among all the 9 508 screening women, 743 cases were detected at high risk,and the positive rate was 7.81%.In which,the Down′ s syndrome（DS） high-risk rate was 5.92%（563/9 508）,the 18-trisome high-risk rate was 0.20%（19/9 508）,the neural tube defects（NTD） high- risk rate was 1.69%（161/9 508）. Karyotype analysis of amniotic fluid cells confirmed DS 5 cases,18-trisomy 1 case,other chromosomal abnormalities 12 cases. The study showed that the high-risk rate of DS and NTD between 4 group（aged 20-, 25-,30- and ≥35） were significantly different（P〈0.01）. The DS high-risk rate of pregnant women aged over 35 was significantly higher than that of pregnant women aged under 35（P〈0.01）. One false positive in DS was found in low risk pregnant women during follow-up. Conclusions：Prenatal serological screening has certain guiding significance in reducing birth defects and improving population qualities.

关 键 词：先天畸形 妊娠中期 血清学 遗传筛查 产前诊断 

分 类 号：R714.5[医药卫生—妇产科学]