杭州市余杭区2009～2012年中孕期二联法血清学产前筛查结果分析

Results of Prenatal Screenings with α-FTP and β-HCG in Mid-Term Pregnant Women From 2009 to 2012 in Yuhang District of Hangzhou

目的评估杭州市余杭区2009—2012年中孕期二联法血清学产前筛查状况及筛查效果。方法回顾性分析2008年10月-2012年9月在杭州市余杭区妇幼保健院自愿接受产前筛查的44566例中孕期妇女二联法血清学产前筛查筛查结果和染色体核型分析情况。结果高风险孕妇中确诊唐氏综合征（DS）胎儿9例，18三体综合征7例，开放性神经管畸形（ONTD）8例，在随访的低风险孕妇中确诊新生儿DS6例，18三体综合征0例，ONTD6例，产前筛查的检出率分别为60．00％（9／15）、100．00％（7／7）、57．14％（8／14）；筛查结果为高风险的孕妇，其检出DS等缺陷胎儿的几率高于低风险者，两者差异有统计学意义（P〈0．001）。结论血清学产前筛查工作取得进展，是降低异常胎儿出生的有效方式，但存在一些假阴性或假阳性病例，应注意筛查结果的解释工作。

Objective To study and evaluate clinical application of prenatal screening with α-FTP and β-HCG in mid-term pregnant women from 2009 to 2012 in Yuhang district of Hangzhou. Methods The results of prenatal screening withα-FTP and β-HCG and chromosome analysis in 44 566 women in the third trimester of pregnancy from August ,2008 to September,2012 in Yuhang Maternal and Child Health Hospital were analyzed respectively. Results Total 9 cases of DS,7 cases of trisomy 18 syn-drome and 8 cases of open neural tube defects（ONTD） were diagnosed from high risky women ;6 cases of Down＇ s syndrome and 6 cases of ONTD were diagnosed from low risky pregnant women. The follow up showed that the positive rate of prenatal screening in high risky women was 60.00% （9/15） , 100.00% （7/7） and 57.14% （8/14） for DS, trisomy 18 syndrome and ONTD, re- spectively;The positive rate of Down＇ s syndrome and other abnormal fetuses by chromosome analysis in the high risky women was higher than that in the low risky pregnant women, and difference between them was statistic significant（ P 〈 0. 001 ）. Conclusion It was an effective indicator in decreasing the birth of abnormal fetuses to perform well the prenatal screening, but the explana- tion must be well carried out on the results being false positive or false negative.