产前母体血清学联合超声软指标检测筛查胎儿染色体异常的应用价值探讨  

Application of ultrasonography combined with serological triad indicators in screening fetal down syndrome

作　　者：周娃娃 符爱贞 高梅 程虹[1] 邱慧玲 ZHOU Wawa;FU Aizhen;GAO Mei;CHENG Hong;QIU Huiling(Department of Obstetrics,Haikou MCH Hospital,Haikou,Hainan 570203,China)

机构地区：[1]海口市妇幼保健院产科,海南海口570203

出　　处：《中国优生与遗传杂志》2021年第1期21-24,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨超声软指标(USM)检查联合血清学三联检测对筛查胎儿染色体异常临床意义。方法选取2017年8月到2020年8月在我院妇产保健门诊及住院在妊娠11^(+1)~13^(+6)周做超声USM扫描(2个及2个以上USM指标异常视为高危),在妊娠14^(+1)~19^(+6)周抽血检测血清三联(AFP、Freeβ-HCG和uE3)筛查(以>380视为高危)的孕妇及其新生儿资料。使用自身对照法,回顾性分析血清三联筛查、超声USM筛查和两者联合使用三种方法之间的准确率、灵敏度以及特异度等指标。结果全部病例13 680例,有效随访者6788例,最终确诊为染色体异常的新生儿为26例,发病率为0.38%。血清三联法诊断为高危孕妇512例,确诊新生儿11例,假阴性诊断10例,假阳性诊断501例,准确度为92.4%,灵敏度为42.31%,特异度为92.59%;超声USM法诊断为高危孕妇463例,确诊新生儿10例,假阴性诊断11例,假阳性诊断453例,准确度为93.09%,灵敏度为38.46%,特异度为93.30%;血清三联和超声USM诊断均异常的高危孕妇74例,确诊新生儿5例,假阴性诊断21例,假阳性诊断69例,准确度为98.67%,灵敏度为19.23%,特异度为98.98%;通过对比单一血清三联法、超声USM法以及血清三联法联合超声USM法的准确率、灵敏度和特异度结果表明:除灵敏度外,血清三联法联合超声USM法的准确率、特异度均高于单一血清三联法、超声USM法,差异具有统计学意义(P<0.01)。结论血清三联联合超声USM法应用于胎儿染色体异常的筛查,可提高其诊断准确率和特异度,具有较高的临床应用价值,值得进一步推广使用。Objective To explore the clinical significance of ultrasound soft index(USM) combined with serological triple detection for screening fetal chromosomal abnormalities. Methods From August 2017 to August 2020, in our Hospital maternity health clinic and hospitalization in the 11^(+1) to 13^(+6) weeks of pregnancy to do ultrasound USM scan(two and more USM indicators abnormal). As a high-risk, blood samples were taken at 14^(+1) to 19^(+6) weeks of pregnancy to detect serum triads(AFP, Freeβ-HCG, and uE3) screening(>380 as high risk) for pregnant women and their newborns. Using the self-control method, the indicators of accuracy, sensitivity, and specificity between the three methods of serum triple screening, ultrasound USM screening, and the combination of the two were retrospectively analyzed. Results There were 13680 cases in all cases, 6788 cases were effectively followed up, and 26 cases were diagnosed as chromosomal abnormalities, with an incidence rate of 0.38%. The serum triad method diagnosed 512 high-risk pregnant women, 11 confirmed neonates, 10 false-negative diagnoses, and 501 false-positive diagnoses with an accuracy of 92.4%, sensitivity of 42.31%, and specificity of 92.59%. Ultrasound USM method was diagnosed as 463 high-risk pregnant women, 10 confirmed neonates, 11 false-negative diagnoses, 453 false-positive diagnoses, accuracy of 93.09%, sensitivity of 38.46%, specificity of 93.30%;serum triad and ultrasound USM diagnosis were abnormally high risk 74 cases of pregnant women, 5 cases of confirmed neonates, 21 cases of false negative diagnosis, 69 cases of false positive diagnosis, the accuracy was 98.67%, the sensitivity was 19.23%, the specificity was 98.98%;by comparing single serum triple method, ultrasonic USM method and The accuracy, sensitivity and specificity of serum triplet combined with ultrasound USM method showed that, besides sensitivity, the accuracy and specificity of serum triple method combined with ultrasound USM method were higher than single serum triple method and ultrasonic

关 键 词：血清三联 超声USM 染色体异常 筛查 

分 类 号：R714.5[医药卫生—妇产科学]