超声软指标联合孕中期血清三联筛查出生缺陷的应用价值  

Application value of ultrasonic soft index combined serum triad indicators during pregnancy in the screening of birth defect

作　　者：陈羽 邬贤凤 徐海耿 CHEN Yu;WU Xian-feng;XU Hai-geng(Department of Obstetrics and Gynecology, Zhoushan Hospital, Zhoushan , Zhejiang 316000, China)

机构地区：[1]浙江舟山医院妇产科,浙江舟山316000 [2]舟山市妇保院妇保科,浙江舟山316000

出　　处：《中国卫生检验杂志》2018年第10期1270-1272,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨超声软指标联合孕中期血清三联筛查出生缺陷的应用价值。方法分析3 253例孕产妇的临床资料,所有孕产妇均经超声软指标诊断,并于孕15周~20周取外周血测定血清甲胎蛋白(AFP)、非结合型雌激素三醇(u E3)及人类绒毛膜促性腺激素(Free-βHCG)。以染色体核型或分娩后追踪结果为金标准分析超声和血清学指标筛查出生缺陷的效能。结果金标准共确诊11例出生缺陷,包括7例21-三体综合征,1例18-三体综合征及3例神经管缺陷。超声软指标单独筛查的敏感度、特异度、阳性预测值、阴性预测值及准确率分别为54.5%、97.4%、6.6%、99.8%及97.2%;血清三联检查上述指标分别为63.6%、98.9%、16.3%、99.9%及98.8%;超声软指标并联血清三联检查上述指标为54.5%、96.7%、7.8%、99.9%及96.6%;超声软指标串联血清三联检查上述指标为81.8%、99.3%、20.0%、99.8%及99.1%。结论超声软指标联合孕中期血清AFP、u E3及Free-βHCG筛查出生缺陷具有较高的临床应用价值。Objective To explore the application value of ultrasonic soft index combined serum triad indicators during pregnancy in the screening of birth defect. Methods Clinical data of 3 253 pregnant women were selected and analyzed retrospectively. All the women got complete ultrasonic soft index,and peripheral blood of 15-20 weeks during pregnancy was extracted to detect alpha fetoprotein（ AFP）,unbinding estrogen-triol（ u E3） and human serum chorionic gonadotropin（ Free-βHCG）.With chromosome karyotyping results and tracking results as golden standard,the clinical screening efficiency of ultrasonic soft index and serum triad indicators was analyzed. Results There were 11 cases of birth defect in all,including 7 Downs syndrome,1 Edwards syndrome and 3 neural tube defects. The sensitivity,specificity,positive predictive value,negative predictive value and accuracy rate of ultrasonic soft index to screen birth defect were 54. 5%,97. 4%,6. 6%,99. 8% and 97. 2%;and those of serum triad indicators were 63. 6%,98. 9%,16. 3%,99. 9% and 98. 8%; those of ultrasonic soft index and serum triad indicators were 54. 5%,96. 7%,7. 8%,99. 9% and 96. 6%; those of ultrasonic soft index or serum triad indicators were 81. 8%,99. 3%,20. 0%,99. 8% and 99. 1%. Conclusion Ultrasonographic soft indicators combined with the serum AFP,u E3 and free-beta HCG has high clinical value for the screening of birth defects.

关 键 词：超声软指标 甲胎蛋白 非结合型雌激素三醇 及人类绒毛膜促性腺激素 出生缺陷 

分 类 号：R714.5[医药卫生—妇产科学]