妊娠早中期整合筛查与中期产前筛查的临床价值比较

Comparing the clinical value of sequential prenatal screening of first-trimester and second-trimester pregnancy with prenatal screening of second-trimester pregnancy

目的：分析比较妊娠早中期整合筛查与妊娠中期筛查方案的筛查效能，探讨妊娠早中期整合筛查的临床价值。方法选取2015年1～12月于本市产前诊断中心进行产前筛查的孕妇作为研究对象，按照自愿选择的原则分为整合筛查组（3265例）及妊娠中期筛查组（5686例），比较两组高风险率、确诊率、检出率、假阳性率、假阴性率及阳性预测值的差异性。结果：与妊娠中期筛查组比较，整合筛查组高风险率明显降低、确诊率有所升高（X2=15．126、3．838，P=0．001、0．032）；检出率、特异性及阳性预测值均高于妊娠中期筛查组（x2=4．424、5．710、53．993，P=0．035、0．017、0．000），假阳性率及假阴性率低于妊娠中期筛查组（x2=81．130、4．958，P=0．000、0．026）。结论：妊娠早中期整合筛查比妊娠中期筛查具有更高的筛查效能及临床价值，值得进一步探讨研究。

Objective： To compare the efficiency of sequential prenatal screening of first-trimester and second-trimester pregnancy with prenatal screening of second-trimester pregnancy. And to explore the clinical value of sequential prena tal screening of first-trimester and second-trimester pregnancy. Method.. From January to December 2015,the pregnant women experienced prenatal screening were recruited , and divided into sequential prenatal screening group （3265 women）and second-trimester pregnancy screening group（5686 women） based on pregnant women voluntary selection. The rate of high risk, rate of diagnosis, rate of detection, rate of false positive, rate of false negative and positive predictive value were compared between two groups. Result..In sequential prenatal screening group, the rate of high risk was significant lower（x2= 15.126, P =0.001）, but the rate of diagnosis was significant higher （x2= 3.838, P = 0. 032）. Rate of detection, specificity, and positive predictive value were significant higher （x2 = 4.424, 5.710, 53.993, P=0.035, 0.017, 0.000）, and rate of false positive and false negative were significant lower（x2 =81.130, 4. 958, P= 0. 000, 0. 026）. Conclusion：The sequential prenatal screening of first-trimester and second-trimester pregnancy is supe rior to prenatal screening of second-trimester pregnancy only, and it is worth to further discussion.