两种孕周确定方法对中孕期唐筛效率的影响  

Effect of Different Gestational Age Determination Methods on the Efficiency of Down Screening in the Second Trimester of Pregnancy

作　　者：曹善楠 巨爱宁 王爱玲 于运亮 马凤超 封建凯 CAO Shannan;JU Aining;WANG Ailing;YU Yunliang;MA Fengchao;FENG Jiankai(Department of Medical Laboratory,Yantai Affiliated Hospital of Binzhou Medical University,Yantai Shandong 264100,China)

机构地区：[1]滨州医学院烟台附属医院检验科,山东烟台264100

出　　处：《中国卫生标准管理》2022年第6期9-12,共4页China Health Standard Management

基　　金：山东省高等学校科技计划项目(J17KB083)。

摘　　要：目的研究不同孕周确定方法对中孕期唐筛风险率和筛查效率的影响。方法选取2016年1月—2019年6月行产前筛查,月经规则且周期在28~30 d的单胎妊娠中孕期孕妇4706例;化学发光法检测血清人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)、非结合雌三醇(uncojugated estriol,uE3)和甲胎蛋白(α-fetoprotein,AFP),采用超声确定孕周(arithmetic ultrasound age,AUA)和末次月经推算孕周末次月经(last menstrual period,LMP)进行胎儿18三体综合征、唐氏综合征及开放性神经管缺陷(open neural tube defects,ONTD)风险评估,比较患病风险率和筛查效率。结果AUA组唐氏综合征临界风险率显著高于LMP组(P<0.05);18三体综合征和开放性神经管缺陷风险率两组间差异无统计学意义(P>0.05);两组间唐氏综合症检出率、假阳性率、阳性预测值差异均无统计学意义(P>0.05)。结论超声确定孕周比用末次月经推算孕周唐氏综合征临界风险率升高,但筛查效率不受影响;对末次月经不明的孕妇,可采用中孕期超声确定孕周进行唐筛风险计算。Objective To explore the effect of different gestational age determination methods on the efficiency of Down screening in the second trimester of pregnancy.Methods A total of 4706 pregnant women in singleton pregnancy with regular menstruation and menstrual cycle between 28 and 30 days from January to September were selected.The level of human chorionic gonadotropin(HCG),unconjugated estriol(uE3)andα-fetoprotein(AFP)of venous blood were detected by chemiluminescence.The risk assessment of 18-trisomy syndrome,Down syndrome and open neural tube defects(ONTD)was conducted using gestational weeks calculated by the last menstruation period(LMP)or arithmetic ultrasound age(AUA)in the second trimester.Compared the different efficiency between the two methods in calculating the risk rate of these syndromes.Results The critical risk rate of Down syndrome of AUA group was significantly higher than that in the LMP group(P<0.05),but there was no significant difference in the risk rates of trisomy 18 syndrome and open neural tube defects between the two groups(P>0.05).There was no significant difference in screening detection rate,false positive rate and positive predictive value of Down syndrome between the two groups(P>0.05).Conclusion The critical risk rate of Down syndrome at gestational age determined by ultrasound was higher than that calculated by the last menstruation,but the screening efficiency was not affected.For pregnant women whose last menstruation is unknown,arithmetic ultrasound age in second trimester of pregnancy can be used to calculate the risk of Down syndrome.

关 键 词：唐氏筛查 唐氏综合征 18三体综合征 开放性神经管缺陷 末次月经 超声 孕周 风险率 

分 类 号：R446[医药卫生—诊断学]