9969例孕中期孕妇产前筛查结果分析

Analysis of screening results to 9969 women at second trimester pregnancy

目的分析孕中期母体血清hAFP、freeβ-HCG、uE3的变化及产前筛查的应用价值。方法采用时间分辨荧光免疫技术检测孕中期母体血清标志物hAFP、freeβ-HCG、uE3的含量,结合孕妇年龄、孕周、体重等因素用Risk2T软件进行风险评估,根据评估结果,将同孕周高、低风险孕妇的hAFP、freeβ-HCG、uE3含量进行统计分析;同时,建议高风险孕妇进一步确诊。结果低风险母体血清hAFP、uE3含量与孕周呈正相关,freeβ-HCG含量与孕周呈负相关;21-三体高风险母体血清hAFP、uE3含量明显低于低风险母体血清该指标含量,差异有统计学意义(P<0.01);而freeβ-HCG含量明显高于低风险时该指标含量,差异有统计学意义(P<0.01);18-三体高风险的母体血清hAFP、freeβ-HCG含量均低于低风险时该指标含量,差异有统计学意义(P<0.01)。9969例孕妇中,筛查出21-三体、18-三体及NTD高风险共288例,筛查阳性率2.9%;107例进行了产前诊断,共确诊19例,确诊率为17.8%,分别为:21-三体6例、18-三体2例,NTD 3例,其他异常儿8例。结论孕中期母体血清3项指标呈规律性变化,检测该指标可发现高风险孕妇;产前筛查结合产前诊断能有效降低出生缺陷率。

Objective： To analyze the change regularity of maternal serum alpha - fetoprotein （AFP） , human chorionic gonadotro- pin （HCG） and non -conpled estriol （uE3） levels among women at second trimester of pregnancy and values of screening. Methods： Time - resolved fluoroimnmnoassay was used to test the serum levels of AFP, HCG, uE3, assessment of the risk was conducted by risk2T software, joined factors such as age, weight and gestational weeks etc. The serum levels of AFP, HCG, uE3 both high and low risk at the same gestational weeks were statisticsed and analyzed. High risk pregnancies would be further diagnosed. Results： The serum levels of AFP and uE3 in low risk pregnancies were direct ratio with gestational weeks, while the serum levels of HCG were opposite. the serum levels of AFP and uE3 in Down syndrome were apparently lower than those in low risk pregnancies （ P 〈 0. 01 ） ; while levels of HCG were adverse （ P 〈 0. 01 ）. The serum levels of AFP and HCG in trisomy 18 syndrome were significantly lower than those in low risk pregnancies （P 〈 O. 01 ）. 288 of screening pregnancies were detected to be suspect, 19of them were diagnosed as followings ： down syndrome 6, trisomy 18 syndrome 2, NTD 3 and others 8. Conclusion： the serum levels of AFP, HCG, uE3 of women at second trimester regularly change, to test it can detect Down syndrome, trisomy 18 syndrome and other defective embryo. So screening can greatly reduce birth defective ratio.