高龄孕妇孕中期血清学产前筛查的临床应用  

The clinical application of serological prenatal screening of second trimester in elderly pregnant women

作　　者：姚静怡[1] 崔岚[1] 岳胜[1] 辛力[1] YAO Jing-yi;CUI Lan;YUE Sheng;XIN Li(Department of Prenatal Screening Test, Tianjin Women＇s and Child＇s Health Center, Tianjin 300070, Chin)

机构地区：[1]天津市妇女儿童保健中心筛查中心,天津300070

出　　处：《中国城乡企业卫生》2018年第4期55-57,共3页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：目的探讨孕中期血清学唐氏综合征(DS)筛查在高龄妊娠妇女中的临床应用价值。方法采用时间分辨荧光分析法检测943例15～20^(+6)周妊娠妇女(预产期年龄≥35岁)的AFP和Freeβ-h CG的浓度,利用风险评估软件(LC4.0)综合妊娠妇女体质量、孕周、预产期年龄、既往吸烟史、糖尿病史评定风险率。设定1/270为DS高风险切割值。对筛查结果为高风险的妊娠妇女建议羊膜腔穿刺确诊胎儿染色体核型;对所有妊娠妇女进行妊娠结局追访。结果高龄妊娠妇女血清学筛查DS高风险率为15.38%(145/943);确诊DS 6例(血清学筛查高风险5例,低风险1例)。结论孕中期血清学DS筛查能够减少不必要的羊膜腔穿刺,为高龄妊娠妇女的遗传咨询提供数据支持。Objective To discuss the clinical application value of the second trimester serum screening for Down syndrome （DS） in elderly pregnant women. Methods The concentration of AFP and Free β-hCG of the 943 pregnant women （the age of expected date of childbirth were more than 35 years） with 15-20＋6 weeks were checked by using Time Resolved Fluorimetric Method. To assess the risk rate combined with the body mass, gestational age, prebirth age, history of past smoking, history of diabetes of pregnant women by using Risk Assessment Software （LC4.0）. Set 1/270 as high risk cutting value of DS. Patients with high risk of second trimester screening were offered amniocentesis to diagnose fetal chromosome karyotype. All pregnant women were recorded pregnancy outcome. Results The high risk rate of the second trimester serum screening of elderly pregnant women was 15.38% （145/943）. 6 cases with DS were identified： 5 cases with high risk; 1 case with low risk. Conclusion The second trimester serum screening can reduce the un- necessary amniocentesis, provide data support for genetic counseling for elderly pregnant women.

关 键 词：唐氏综合征 妊娠中期 产前筛查 

分 类 号：R459.6[医药卫生—治疗学]