1798例孕早中期整合筛查筛查效果分析

Results analysis on Integrated screening of 1798 cases

目的对比分析孕早中期整合筛查与孕中期三联产前筛查对检出胎儿染色体异常和神经管畸形的筛查效率,探讨整合筛查的临床价值,寻求更好的产前筛查模式。方法 1798名孕早中期整合筛查孕妇孕早期(11w^13+5w)检测血清标志物PAPP-A、Freeβ-HCG,同时B超测量胎儿颈项透明层厚度(NT),于孕中期(15w^19+6w)测定血清标志物AFP、Freeβ-HCG、uE3,同期4295名孕妇行孕中期三联筛查(检测母血清标志物AFP、Freeβ-HCG、uE3),对筛查高风险孕妇进行后续产前诊断,并对妊娠结局进行随访,将两组筛查效果进行对比分析。结果整合筛查组高风险筛查高风险率1.06%,假阳性率0.95%,明显低于中期筛查组,两组差异有显著统计学意义。结论整合筛查组具有更低的假阳性率,避免了很多不必要的侵入性的产前诊断,是更有效的产前筛查模式。

Objective： To discuss the clincical significance by means of comparing and assessing the effectiveness on detection of fetal chromosomal abnormalities and neural tube of integrated screening and the second trimester prenatal screening. Methods： 1798 pregnant women detected the levels of serum PAPP-A, Freeβ-HCG between 11 and 13＋5 weeks of pregancy and mean while mensurated NT, then detected the levels of serum AFP, Freeβ-HCG, uE3 at 15-19＋6 weeks. At the same term 4295 cases of pregnany just detected the levels of serum AFP, Freeβ-HCG, uE3 at 15-19＋6 weeks. The results of following prenatal diagnosis and pregnancy outcomes were followed up. Results： The high risk rate and the false positive rate of integrated screening group is 1.06% and 0.95% respectively.They were significantly lower than The second trimester prenatal screening group. There was significant difference between two groups. Conclusion： The false positive rate of integrated screening group is more lower to avoid a lot of prenatal diagnosis of invasive unnecessary. It＇s more effective.