金华地区产前筛查孕中期中位数倍数的应用

The application of second trimester prenatal screening Multiples of the Median(MoM) in Jinhua

目的对金华地区孕中期孕妇的血清标志物中位数倍数进行统计分析,了解本地区正常与缺陷儿孕妇的血清标志物中位数倍数,以防缺陷儿的出生。方法利用美国Perkin Elmer公司Auto DELFIA全自动时间分辨荧光免疫分析仪对20232例孕中期单胎孕妇血清（孕周在15～20^＋6w）各标志物浓度进行检测分析,用Lifecycle3.2软件计算唐氏综合征风险,拟合出的符合本地中位数方程计算唐氏综合征风险。结果显示随孕周增加,血清AFP和u E3值有明显增加趋势,分析呈正相关（P〈0.01）;而freeβ-h CG值水平明显降低,呈负相关（P〈0.01）,孕妇体重随着孕周的增加而增加,各血清标志物与体重呈负相关（P〈0.01）;在确诊的唐氏综合征、开放性神经管畸形、18-三体综合征的病例中相关孕妇血清指标Mo M值表现为异常。结论当有血清标志物Mo M值明显大于或小于正常时应召回孕妇做进一步的产前咨询与诊断,以防缺陷儿的出生。

Objectives：The second trimester maternal serum markers median multiples of Jinhua area were statistical analysis. Understanding of normal and defective children in the region maternal serum markers median multiples to prevent birth defects in children. Methods：American Perkin Elmer Company Auto DELFIA automatic time-resolved fluorescence immunoassay analyzer was used to detect 20 232 cases of second trimester single fetus（gestational age at 15-20^＋6 weeks）maternal serum. The risks of Down syndrome were calculated by Lifecycle3.2 software. Local median formulas of each marker were regressed with local mark median concentrations. Results：Serum AFP and u E3 concentration values significantly increase with gestational age;trend analysis showed a positive correlation（P〈0.01）. While free β-h CG concentration levels were significantly decrease-negative correlation（P〈0.01）. Maternal weight increases with gestational week and each serum markers were negatively correlated with weight（P〈0.01）. In the diagnosis of Down syndrome,Open Neural Tube Defect and 18-trisomy cases related pregnant women Mo M values of serum markers showed abnormalities. Conclusions：When serum marker Mo M values significantly greater than or less than the normal,pregnant women should be recalled for further counseling and prenatal diagnosis to prevent birth defects in children.