血清学指标结合颈部透明膜产前筛查21-三体综合征的Meta分析

Meta-analysis of prenatal screening for trisomy 21 using nuchal translucency measurement with serum markers

目的:探讨孕早期血清生化标记物结合颈部半透明膜厚度(NT)在产前超声筛查21-三体综合征中的价值.方法:检索Cochrane图书馆,PubMed,OVID,Springer数据库,中国期刊网和中国生物医学文献数据库1990-01/2008-08(1990-01/2008-08)中的中、英文文献,按照诊断试验的纳入标准筛选文献,收集所有相关的诊断实验文献,应用Meta-DiSc1.4软件对符合条件的研究结果进行Meta分析.结果:共纳入文献14篇,筛查胎儿共计111535人.汇总灵敏度、特异性和95%CI分别为0.89(95%CI:0.87～0.91),0.96(95%CI:0.96～0.96);绘制由于受试者工作特征(SROC)曲线其曲线下面积(AUC)为0.971.结论:孕早期血清生化标记物结合NT厚度对21-三体综合征产前诊断的敏感性、特异性和诊断的准确性均较高,可用于孕早期21-三体综合征的产前筛查.

AIM： To evaluate the value of screening trisomy 21 by nuchal translucency（NT） measurement together with maternal serum biochemistry markers in first trimester. METHODS： A search was performed in Cochrane Library, Pub Med, OVID, Springer, China National Knowledge Infrastructure （CNKI） and Chinese Bio-medicine Database （CBM）to obtain relevant English and Chinese literature between January 1990 and August 2008. Criteria for inclusion were established based on the validity criteria for diagnostic research. The criteria-meeting data were collected and analyzed using Meta-DiSc 1. 4. RESULTS： Fourteen research articles were included, with a total of 111 535 fetuses. These articles were analyzed for the value of screening of trisomy 21 using nuchal translucency （NT） measurement together with maternal serum biochemistry markers in first trimester. The pooled sensitivity and specificity were 0. 89 （95% CI： 0. 87 - 0.91 ） and 0.96 （95 % CI ： 0.96 - 0.96 ） respectively. The SROC curve was drawn and the area under the curve （AUC） was calcu- lated（ AUC = 0. 971 ）. CONCLUSION ： The results suggest that the screening of trisomy 21 by elevated NT together with maternal serum biochemistry markers has a high sensitivity, specificity and accuracy and is suitable for prenatal screen.