提高集中筛查模式下唐氏综合征筛查效率的研究

Evaluation on the screening efficiency for Down syndrome under a centralized blood processing model

目的通过集中化筛查模式下的唐氏综合征产前筛查数据分析,了解样本分析前的影响因素,为提高集中筛查模式的筛查质量提供依据。方法对2011年1月～6月参加筛查的宁波市孕妇29 349例,分别将集中或分散二种不同采血方式和不同血清分离方式的血清样本检验结果进行质控分析,并对质控后的1557例数据进行再分析。数据比较采用t检验,P﹤0.05为差异有统计学意义。结果集中采血方式下Freeβ-hCG水平偏高,uE3水平偏低Free(P=0.000);采用分离胶管分离血清法,Freeβ-hCG和uE3水平均偏高(P=0.025,P=0.000)。结论血样本室温下放置过久和分离胶真空采血管分离血浆,会影响产前筛查标志物的检测结果。规范样本采集、贮存、递送流程,使用普通管-离心法分离血清,有利于产前筛查效率的保证。

Objective To evaluate the screening efficiency of centralized blood processing model for Down syn- drome among pregnant women by analyzing the prenatal screening data, to understand the influencing factors and to provide evidence for improving the quality of screening. Methods Data of 29349 pregnant women whose serum samples were collected and separated in two different ways from January 2011 to June 2011 in Ningbo were analyzed for the purpose of quality control analysis and 1557 of them were re-analyzed. T-test was used for statistical analysis. Results A higher level of Free β-hCG and a lower level of uE8 were noticed under centralized blood processing model compared with a scattered blood processing method （P = 0. 000）, and both levels were higher when serum was separated using gel tube （P = 0. 025, P= 0. 000）. Conclusions Blood samples stored at room temperature for too long or use of gel tube to separate serum may influence the results of prenatal screening makers for Down syndrome. Therefore, standardized sample collection, storage and delivery as well as use of conventional tube to separate serum may improve the prenatal screening efficiency for Down syndrome among pregnant women.