吉林地区21234例孕中期三联筛查病例及随访分析

Retrospective analysis of 21234 cases pregnancies of second-trimester triple-marker screening in Jilin area

目的 回顾性分析2010-2013年吉林地区孕中期三联筛查临床应用情况及其影响因素。方法 孕中期（15-20＋6周）采血,利用时间分辨荧光免疫分析法测定血清AFP、Freeβ-HCG和u E3。结合年龄、体重、孕周等因素,通过Life Cycle风险评估软件估算风险值,筛选高风险孕妇,并对其妊娠结局进行随访。结果 21 234例孕妇中,高风险1266例,筛查阳性率5.96%。不同年龄、体重、孕周分布,筛查阳性率不尽相同。随访15 486例孕妇,发现240例不良妊娠结局。结论 孕中期三联筛查结果受年龄、体重、孕周因素影响。结合产前诊断和随访观察,可有效降低吉林地区缺陷胎儿出生率。

Objective： Analyze retrospectively clinical applications of 21 234 cases pregnancies of second-trimester triple-marker screening in Jilin area during 2010-2013. Methods： Serum samples were collected during second trimester （15-20＋Sweeks） and triple markers （AFP, Free β-HCG and uE3） were determined by time-resolved fluoroimmunoassay method. In combination with maternal age, weight and gestational weeks et al, we evaluated the risk with assessment software to select high-risk pregnancies. Results： There are 1266 cases high-risk pregnancies in 21 234 cases pregnancies and the positive rate of screening is 5.96%. The positive rates of screening are different in various groups of maternal age, weight, gestational weeks. There are 240 cases adverse obstetrical outcomes through follow-up visit of 15 486 pregnancies. Conclusion： Second-trimester triple-marker screening （AFP＋Free I3-HCG＋uE3） is an effective approach to predict abnormal fetuses, which is affected by age, weight, gestational weeks. In combination with follow-up visits and prenatal diagnosis, the screening can reduce birth defects in Jilin area.