中山市孕中期产前筛查指标中位数的建立及临床价值研究  

The establishment and clinical value of the median of screening serum-markers for second-trimester pregnant women in Zhongshan

作　　者：李冬秀 吴学威 黄湘 钟裕恒 梁睿 LI Dongxiu;WU Xuewei;HUANG Xiang;ZHONG Yuheng;LIANG rui(Prenatal Diagnosis Center,Boai Hospital Affiliated to Southern Medical University,Zhongshan,Guangdong,China,52840)

机构地区：[1]南方医科大学附属中山博爱医院产前诊断中心,广东中山528403

出　　处：《分子诊断与治疗杂志》2018年第4期278-282,共5页Journal of Molecular Diagnostics and Therapy

基　　金：中山市科技计划项目(2015B1182)

摘　　要：目的研究中山市孕中期妇女产前筛查指标的中位数,比较本地与内置中位数方程对产前筛查效率的影响。方法采用时间分辨荧光分析法检测2016年1至12月孕中期血清标本的游离β-人绒毛膜促性腺激素(free-β-HCG)、甲胎蛋白(AFP)、游离雌三醇(u E3)的浓度,比较本地人群和高加索人群间各孕周free-β-HCG、AFP和uE3中位数的差异,并比较内置方程和本地方程对2016年1至12月正常孕妇血清学筛查指标MoM中值的影响。分别应用本地方程和内置方程计算不同孕妇18三体和21三体的风险值,统计分析本地与内置方程对孕中期产前筛查效率的影响。结果各孕周孕妇的free-β-HCG和u E3中位数均比高加索人群高,而AFP中位数值在本地和高加索人群间没有显著差异。内置方程和本地方程对2016年1至12月正常孕妇血清学筛查指标MoM中值具有显著差异。本地方程和内置方程对21三体的检出率都是75%(12/16);本地方程特异性为95.56%,内置方程为91.52%。对于18三体,本地方程比内置方程的检出率提高了50%。结论中山地区孕中期产前筛查指标的中位数与高加索人群存在较大差异,经过本地化调整的中位数方程能够提高产前筛查的效率,更适用于中山地区人群。Objective To investigate the median of screening serum-markers for second-trimester pregnant women in Zhongshan,and to compare the impact of the local and built-in median equations on the efficiency of prenatal screening. Methods Time-resolved fluorescence spectrometry was used to detect freeβ-human chorionic gonadotropin（free-β-HCG）,alpha-fetoprotein（AFP）and free estriol（uE3）in serum from January to December 2016. The concentration of free-β-HCG,AFP,and uE3 in gestational weeks was compared between the local population and the Caucasian population. The built-in equations and local equations were compared to the effect of Mo M median on serological screening in healthy populations from January to December 2016. The local equations and built-in equations were applied to calculate the risk values of 18 trisomy and 21 trisomy for different pregnant women,and the effects of local and built-in equations on the prenatal screening efficiency in the second trimester were statistically analyzed. Results The median of free-β-HCG and uE3 of second-trimester pregnant women of different gestational age were higher than Caucasian population. But there was no significant difference on the median of AFP between them. There were significant differences between the MoM median of screening serum-markers from January to December 2016 of local and built-in software median equation. The positive detection rate of local and built-in software for trisomy 21 were both 75%. The specificity of local software was 95.56% and the built-in software 91.52%.The positive detection rate for trisomy 18 of the local median equation was 50% up than the built-in equation.Conclusion The median prenatal screening index in mid-pregnancy in Zhongshan is quite different from the Caucasian population. The localized adjusted median equation can improve the efficiency of prenatal screening and is more suitable for people in Zhongshan

关 键 词：孕中期 质量控制 产前筛查 唐氏综合征 

分 类 号：R714.5[医药卫生—妇产科学]