孕中期AFP,UE_3,β-HCG联合筛查唐氏综合征临床分析

Clinical analysis of the combined screening of AFP,UE_3,β-HCG on diagnosis for the Down syndrome at the second trimester of pregnancy

[背景]探讨孕中期唐氏综合征产前筛查的方法及影响其风险值的主要因素.[病例报告]采用全自动化学发光免疫分析仪检测950例孕14～20周孕妇血清甲胎蛋白(AFP)、游离雌三醇(UE3)及人绒毛膜促性腺激素β-亚单位(β-HCG)值,应用美国贝可蔓公司提供的软件对AFP,UE3,β-HCG值进行风险分析,以风险比1∶380为切割点,判断950例孕中期胎儿的风险情况.风险比高于1∶380以上者为10例,其中5例进行了羊水穿刺,经染色体核型分析确诊1例,待分娩后确诊其余胎儿均为阴性,在高危孕妇中阳性率为10.0%.[讨论]上述3个指标联合筛查为较理想的产前唐氏综合征筛查模式.

BACKGROUND To study the method of prenatal screening for Down syndrome at the second trimester of pregnancy and main factors of affecting its value-at-risk. CASE REPORTS The value of AFP ,UE3,β-HCG in serum of 950 cases of pregnant women at 14～20 weeks were detected by the automated Chemiluminescence Immunoassay System,and the value-at-risk was analyzed by using analytical software provided from Beckman Corporation in America. The risk-rate was 1∶380 as the cut-off point to analyze risk status in 950 cases of second trimester fetuses.10 of second trimester fetuses were over 1∶380 risk rate,in which 5 cases were performed amniocentesis and 1 case was diagnosed to the Down syndrome by karyotype analysis of chromosome in amniotic fluid,the other 5 cases refused invasive procedures,but diagnosed negative after childbirth,and positive rate was 10.0%. DISCUSSION The combined screening of AFP,UE3,β-HCG in serum is ideal prenatal screening model of diagnosis for the Down syndrome.