基于年龄与孕周对唐氏综合征血清学产前筛查结果影响的回顾性分析

Retrospective analysis on the effects of base on the maternal age and gestational week on serological prenatal screening results of Down′s syndrome

目的探讨基于年龄与孕周对唐氏综合征(Down′s syndrome,DS)血清学产前筛查结果的影响,进而据此总结DS血清学产前筛查的理想孕周。方法回顾性分析本院7958例孕15~20^(+6)w进行DS血清学产前筛查孕妇的甲胎蛋白(alpha fetoprotein,AFP)和β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-HCG)检测结果,并对筛查高危孕妇实施羊水细胞染色体诊断,对比相同年龄段不同孕周DS的假阳性率及不同年龄段DS的风险率。结果 (1)在7958例受检孕妇中,DS高危及确诊者分别为296例和7例,筛查假阳性率3.63%。(2)孕17~18^(+6)周DS筛查的假阳性率3.16%~3.11%,明显低于孕15~16^(+6)w及孕19~20^(+6)w的假阳性率,差异有统计学意义(P<0.05)。(3)DS产前筛查的风险率可随年龄增长而增加,差异均存在统计学意义(P<0.05)。结论 (1)孕妇的年龄是导致DS发病的独立高危因素。(2)在孕15~20^(+6)周检测AFP和β-HCG可有效检出DS患儿,降低其出生率。(3)为了提高DS的检出率,建议血清学产前筛查在17~18^(+6)w。

Objective： To explore the effects of base on the maternal age and gestational week on serological prenatal screening results of Down＇ s syndrome, and try to find the best sensitive period for prenatal screen. Methods： Selected 7958 cases of 15-20＋6 weeks gestation in our hospital to do the DS serology prenatal screening on the test results of alpha fetoprotein and β-human chorionic gonadotropin were retrospectively analyzed. And for high-risk pregnant women were diagnosed by amniotic fluid cells chromosome.Compared to the same age of different gestational week DS of false positive rate and the risk rate of different age paragraph. Results： （1）In 7958 cases of pregnant women tested, DS of high endanger and confirmed 296 cases and 7 ones respectively, screening false-positive rate was 3.63%.（2）The 17-18 ＋6 weeks gestation DS screening the false positive rate of 3.16%-3. 11%, which was significantly lower than 15- 16 ＋6 and 19-20 ＋6 weeks gestation of false positive rate.The difference was statistically significant （P〈0.05） . （3）The DS screening of the risk increases with older.The difference was also statistically significant （P〈0.05） . Conclusion： （1）The maternal age is independent risk factor of DS. （2）In 15-20 ＋6 weeks gestation detecting AFP and β-HCG can effectively find DS children so that reducing the birth rate.（3）In order to improve the detection rate of DS, it is recommended that the serological prenatal screening in 17- 18 ＋6 weeks.