29243例妊娠中期血清学标记物本地化实验数据的应用及分析  

Application and Analysis of Localization Experimental Data of Serological Markers in the Second Trimester Pregnancy of 29243 Cases

作　　者：张杰 马倩 游园园 ZHANG Jie;MA Qian;YOU Yuanyuan(Department of Genetics,Maternity and Child Health Care Hospital,Shenyang 110000 China)

机构地区：[1]沈阳市妇幼保健院遗传科,沈阳110000

出　　处：《内蒙古医学杂志》2024年第11期1290-1293,共4页Inner Mongolia Medical Journal

摘　　要：目的通过对沈阳市及其周边地区孕中期孕妇血清学标记物游离β-人绒毛膜促性腺激素(Freeβ-HCG)、甲胎蛋白(AFP)、游离雌三醇(uE3)等筛查指标结果的分析,比较应用校正中位数方程后筛查阳性率及检出率的变化,建立沈阳地区的产前筛查中位数方程,探讨校正方程对应用效能的影响。方法对29243例就诊于沈阳市妇幼保健院的孕妇进行三联(Freeβ-HCG、AFP、uE3)血清学筛查,采用已进行本地化中位数倍数(MoM)校正的LifeCycle 4.0软件进行风险评估。并与软件通用方程分析结果进行对比,分析校正方程前后筛查阳性率的变化,建立适用于本地区的中位数方程。结果(1)应用校正中位数方程后,3种血清学标记物中位数MoM值更趋近于1.0;(2)应用校正方程风险评估结果的阳性率由6.72%降至5.67%,假阳性率由6.65%降至5.59%,唐氏综合征(DS)的检出率由72.4%升至82.7%,整体的筛查效率高于通用方程。结论经过对孕周、体质量标化调整后,建立沈阳地区孕中期血清学标记物Freeβ-HCG、AFP、uE3的本地化中位数方程,可降低筛查阳性率,提高DS的检出率,提高整体的筛查效率。Objective This paper aims to establish a localized median equation applicable of prenatal screening in Shenyang and discuss the effect of localized median equation on application efficiency by analysing the results of Serum alpha-fetoprotein(AFP),freeβ-hCG,and free estriol(uE3)in Shenyang and its surrounding areas during the second trimester and comparing the changes of screening positive rate and detection rate after using the localized median equation.Method Perform triple therapy(Freeβ-HCG,AFP,uE3)on 29243 pregnant women who underwent prenatal screening in Shenyang Maternity and Child Health Care Hospital seeking medical treatment serological screening was conducted using LifeCycle4.0 software with localized median multiple(MoM)correction for risk assessment.Compare the results with the software general equation analysis,analyze the changes in screening positive rate before and after correcting the equation,and establish a median equation suitable for our laboratory.Results(1)After applying the correction equation for localized median,the median of Freeβ-HCG,AFP,and uE3 serological markers are closer to 1.0;(2)The positive rate of risk assessment using the correction equation decreased from 6.72%to 5.67%,the false positive rate decreased from 6.65%to 5.59%,and the detection rate of Down syndrome(DS)increased from 72.4%to 82.7%.The overall screening efficiency was higher than that of the general equation.Conclusion After standardizing and adjusting the gestational,age and weight,a mid pregnancy serological marker was established in laboratory.Localized median equations for Freeβ-HCG,AFP,and uE3 can reduce the positive screening rate,improve the detection rate of DS,and improve overall screening efficiency.

关 键 词：血清学筛查 唐氏综合征 中位数方程 假阳性率 筛查效率 

分 类 号：R714.5[医药卫生—妇产科学]