陕西地区26 140份孕中期唐氏综合征筛查报告分析  

Analysis of 26 140 cases of second trimester pregnancy Down syndrome screening reports in Shaanxi Province

作　　者：沈鑫[1] 孙杨[2] 翟卫斌 袁晓华[1] 范芸[4] 黄晓燕[5] 徐翠香[5] SHEN Xin;SUN Yang;ZHAI Weibin;YUAN Xiaohua;FAN Yun;HUANG Xiaoyan;XU Cuixiang(Obstetrics and Gynecology Hospital,Shaanxi Provincial People′s Hospital,Xi′an,Shaanxi 710068,China;Data Center,Shaanxi Provincial People′s Hospital,Xi′an,Shaanxi 710068,China;Department of Information,Shaanxi Provincial People′s Hospital,Xi′an,Shaanxi 710068,China;Department of Clinical Laboratory,Shaanxi Provincial People′s Hospital,Xi′an,Shaanxi 710068,China;Shaanxi Provincial Key Laboratory of Infection and Immune Diseases,Shaanxi Provincial People′s Hospital,Xi′an,Shaanxi 710068,China)

机构地区：[1]陕西省人民医院妇产病院,陕西西安710068 [2]陕西省人民医院数据中心,陕西西安710068 [3]陕西省人民医院信息处,陕西西安710068 [4]陕西省人民医院检验科,陕西西安710068 [5]陕西省人民医院陕西省感染与免疫疾病重点实验室,陕西西安710068

出　　处：《检验医学与临床》2021年第8期1068-1071,1074,共5页Laboratory Medicine and Clinic

摘　　要：目的探讨孕中期唐氏综合征筛查报告各指标不同孕周变化趋势和影响因素,建立该地区孕中期不同孕周指标参考区间及中位数参考值,提高筛查效率。方法选取2015年1月至2019年12月在陕西省人民医院行孕中期唐氏综合征产前筛查的26 140例自然妊娠孕妇为研究对象,记录血清生化甲胎蛋白(AFP)、游离雌三醇(uE3)、绒毛膜促性腺激素(HCG)水平,描述不同孕周孕妇筛查指标的参考区间及中位数。结合产前检查资料用软件评估计算21-三体综合征(DS)、18-三体综合征(ES)、开放性神经管缺陷(NTD)风险率,并分析不同年龄、不同体质量、不同孕周孕妇DS、ES、NTD检出情况的差异。结果初步建立了该地区的孕中期不同孕周血清DS筛查指标参考区间及中位数参考值,AFP、uE3水平从孕14~21周逐步上升而HCG值从孕14~21周逐步降低。26 140例孕妇中DS高风险1 841例(7.04%)、ES高风险166例(0.64%)、NTD高风险456例(1.74%)。不同年龄组间孕妇DS、ES筛查高风险率差异有统计学意义(P<0.05),且年龄>35岁组的孕妇DS、ES筛查高风险率高于其他年龄组(P<0.05),而不同年龄组间孕妇NTD筛查高风险率差异无统计学意义(P=0.12);不同体质量组孕妇DS、ES筛查高风险率差异有统计学意义(P<0.05),而不同体质量组孕妇NTD筛查高风险率差异无统计学意义(P=0.62),体质量>65kg组的孕妇DS、ES筛查高风险率高于其他体质量组(P<0.05);不同孕周组孕妇DS、ES、NTD筛查高风险率差异有统计学意义(P<0.05)。DS筛查高风险率在孕14、15周与其他孕周(16~21周)间差异有统计学意义(P<0.05);ES筛查高风险率在孕14、15周与孕16~19周间差异有统计学意义(P<0.05),而NTD筛查高风险率仅在孕15周和19周间差异有统计学意义(P<0.05)。结论建立该地区孕中期不同孕周血清唐氏综合征筛查指标参考区间及中位数参考值意义重大;高龄及高体质量孕妇患DS、ES的风险提高,育�Objective To explore the change trend and influencing factors of different gestational weeks in the second trimester Down′s syndrome screening report,and to establish the reference interval and median reference value of different gestational weeks indexes in the second trimester in this area for improving the screening efficiency.Methods A total of 26140 natural pregnancy pregnant women undergoing prenatal screening in the second trimester Down′s syndrome prenatal screening in the Shaanxi Provincial People′s Hospital from January 2015 to December 2019 were selected as the research subjects.Serum alpha-fetoprotein(AFP),uncojugated estriol(uE3)and human chorionic gonadotropin(HCG)levels were recorded to describe the reference interval and median of screening indicators for pregnant women of different gestational weeks.The risk rates of 21-trisomy syndrome(DS),18-trisomy syndrome(ES)and open neural tube defect(NTD)were evaluated and calculated by using the software and combining with prenatal examination data.The differences in the detection rates of DS,ES and NTD among different ages,different body masses and different gestational weeks were analyzed.Results The reference intervals and median reference values of serum Down′s syndrome screening indexes for different gestational weeks in the second trimester of pregnancy in this local area were preliminarily established.The AFP and uE3 levels were gradually increased from 14 weeks to 21 weeks of pregnancy,while the HCG level was gradually decreased from 14 weeks to 21 weeks of pregnancy.Among 26140 pregnant women,there were 1841 cases(7.04%)of high-risk DS,166 cases(0.64%)of high-risk ES,and 456 cases(1.74%)of high-risk NTD.There was statistically significant differences in the risk ratio of DS and ES among different age groups,and the risk ratio of DS and ES in the age>35 years old group were higher than those in the other age groups(P<0.05).There was no statistically significant difference in the risk ratio of NTD among different age groups(P=0.12).The diff

关 键 词：孕中期 唐氏综合征 产前筛查 

分 类 号：R714.55[医药卫生—妇产科学]