血清AFP、uE-3及β-HCG联合测定对孕中期筛查胎儿先天性缺陷的应用意义  

The significance of combined detection of serum AFP,uE-3 andβ-HCG in screening fetal congenital defects in pregnant women at the second trimester

作　　者：王永栋 王莹 张飞 李跃晨 孙其桓 李洲锋 WANG Yongdong;WANG Ying;ZHANG Fei(Ningjin County Hospital,Hebei,Ningjin 055550,China)

机构地区：[1]河北省宁晋县医院,055550 [2]石家庄华药医院检验科 [3]河北省饶阳县人民医院

出　　处：《河北医药》2022年第1期97-99,103,共4页Hebei Medical Journal

摘　　要：目的探讨血清甲胎蛋白(AFP)、游离雌三醇(uE-3)及β绒毛膜促性腺激素(β-HCG)联合测定对孕中期女性筛查胎儿先天性缺陷的意义。方法选取2018年5月至2019年5月行传统产前检查的怀孕中期妊娠女性620例,血清学检查测定AFP、uE-3及β-HCG水平。对测定后的结果可能出现的各种风险进行评估,对胎儿的NT值进行测量和分析。取高风险组孕妇的羊水进行染色体疾病的确诊。结果联合测定血清AFP、uE-3及β-HCG对主要的先天性缺陷的筛查较传统的血清学筛查效果要好,筛查后高、低风险组联合测定血清AFP、uE-3及β-HCG水平的差异有统计学意义(P<0.05)。不同胎儿之间的NT值存在显著不同(F=244.586,P=0.000),头部和臀部的直径呈正相关关系(F=0.423,P=0.001)并且随着孕周的增长,NT值也会逐渐增加。与羊水穿刺的结果进行分析,血清联合测定对先天性缺陷的确诊率为10.0%;以羊水穿刺诊断结果作为金标准,血清AFP、uE-3及β-HCG联合测定的灵敏度、特异度分别为75.00%、78.57%。结论血清联合测定对筛查胎儿先天性缺陷效果较好,值得推广。Objective To investigate the significance of combined detection of serum alpha-fetoprotein(AFP),free estriol uE-3(uE-3)andβ-HCG in screening fetal congenital defects in pregnant women at the second trimester.Methods A total of 620 pregnant women at the second trimester who underwent prenatal examination in our hospital from May 2018 to May 2019 were enrolled in the study.The serum levels of AFP,uE-3,β-HCG were detected.And the various risks were evaluated.Moreover the amniotic fluid in e high-risk group was diagnosed for chromosomal disease.Results The results of combined detection of serum AFP,uE-3 andβ-HCG were superior to those by traditional serological screening.There were significant differences in the serum levels AFP,uE-3 andβ-HCG between high risk group and low risk group(P<0.05).The results of amniotic fluid puncture showed that the definite diagnosis rate of congenital defects by combined detection was 10.0%,and the sensitivity and specificity were 75.00%and 78.57%,respectively.Conclusion The combined detection of serum AFP,uE-3 andβ-HCG can obtain better results in screening fetal congenital defects in pregnant women at the second trimester,therefor,it is worthy of clinical promotion.

关 键 词：甲胎蛋白 游离雌三醇 Β绒毛膜促性腺激素 孕中期 胎儿 先天性缺陷 

分 类 号：R714.5[医药卫生—妇产科学]