某市31216例孕中期唐氏综合征血清筛查结果分析  

Analysis of results of serum screening in Down′s syndrome in 31 216 pregnant women at the second trimester

作　　者：黄德芳[1] 刘党英[1] HUANG Defang;LIU Dangying(Department of Clinical Laboratory,Gaoyou Maternal and Child HealthcareHospital,Gaoyou,Jiangsu 225600,China)

机构地区：[1]江苏省高邮市妇幼保健院检验科,225600

出　　处：《检验医学与临床》2018年第23期3560-3562,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨孕中期唐氏综合征血清筛查阳性率的影响因素。方法检测31 216例孕中期孕妇血清甲胎蛋白、游离雌三醇、游离人绒毛膜促性腺激素β-亚单位水平。通过对检测结果进行分析,结合年龄、体质量、孕周和筛查日期等影响因素,评估唐氏综合征、18三体综合征和开放性脊柱裂的高危风险。结果筛查出唐氏综合征高风险1 173例,筛查阳性率为3.76%;筛查出18三体高风险57例,筛查阳性率为1.83‰;筛查出开放性脊柱裂高风险144例,筛查阳性率为4.61‰。30岁以上年龄组(30～38岁)与30岁以下年龄组(17～<30岁)唐氏综合征阳性率差异有统计学意义(P<0.05);>34～38岁年龄组与其他年龄组18三体综合征和开放性脊柱裂阳性率比较,差异有统计学意义(P<0.05)。唐氏综合征、18三体综合征阳性率与体质量无明显相关性,高体质量组(75～<100kg)相比低体质量组(<75kg)开放性脊柱裂阳性率明显较低,差异有统计学意义(P<0.05)。孕15周、16周和21周唐氏综合征筛查阳性率较高,与其他孕周组比较,差异有统计学意义(P<0.05)。孕15周18三体综合征阳性率较其他孕周18三体综合征阳性率显著升高(P<0.05)。2008-2011年唐氏综合征筛查阳性率较低,2012-2018年唐氏综合征筛查阳性率较高。结论孕妇年龄是唐氏综合征高风险的一个重要影响因素,因此建议适当早育,或可减少高危缺陷儿出生。Objective To analyze the factors influencing the positive rate of serum screening in Down′s syndrome in the second trimester. Methods Serum levels of alpha fetoprotein,free estradiol and free human chorionic gonadotropin-beta subunit were measured in 31 216 pregnant women at the second trimester.The risk of Down′s syndrome,Edwards′ syndrome and Opened Spina Bifida were evaluated by analyzing the results of the screening tests,combined with factors such as age,weight,gestational week and screening date. Results A total of 31 216 pregnant women were included in this study,and 1 173 cases with Down′s syndrome （ 3.76 %）.Edwards′ syndrome and Opened Spina Bifida were 1.83‰ and 4.61‰.The positive rates of Down′s syndrome in the age older than 30 years old （30-38 years） had statistical difference with the age younger than 30 years old（17-29 years）（ P 〈0.05）.The positive rates of Edwards′ syndrome and Opened Spina Bifida in 35 to 38 years old group had statistical difference with the other groups.There was no significant correlation between the positive rates of Down′s syndrome,Edwards′ syndrome and Opened Spina Bifida with the body weight.At 15 weeks,16 weeks and 21 weeks,the positive rates of Down′s syndrome were higher, 9.39 %, 7.34 % and 8.33%,respectively,which were significantly different from those in other gestational weeks.At 15 weeks,the positive rates of Edwards′ syndrome were significantly higher than the other gestational weeks.From 2008 to 2011,the positive rates of the Down′s syndrome were 1.48%,2.17%,1.22% and 2.36% respectively.The positive rates of the Down′s syndrome were higher in 2012 to 2018,which were 4.25%, 5.73 %,3.46%,3.86%,5.88%,4.03% and 3.79%,respectively. Conclusion The age of pregnant women is an important factor contributing to the high risk of Down′s syndrome,early childbirth should be recommended for the reduction of high-risk birth defects.

关 键 词：产前筛查 唐氏综合征 甲胎蛋白 游离雌三醇 游离人绒毛膜促性腺激素β-亚单位 

分 类 号：R714.55[医药卫生—妇产科学]