干血斑法在兰州市孕期妇女唐氏综合征筛查中的应用

Application of dried blood spot method in Down's syndrome screening among pregnant women in Lanzhou

目的比较干血斑法和血清法在中孕期产前筛查检测的一致性,探讨其筛查效果并对可行性进行评价,初步建立适用于本地区的中孕期干血斑唐氏综合征筛查技术。方法收集2013年6月-2016年6月在甘肃省妇幼保健院产检,来自于兰州市的接受中孕期产前筛查且符合入选条件的孕妇血清及干血斑标本,同时行血清法二联筛查(AFP+Freeβ-hCG)及干血斑法筛查;随访妊娠结局并比较两者的一致性、筛查效率及诊断价值。结果共18 459例标本纳入研究,随访妊娠结局14 951例,对于21-三体综合征、18-三体综合征、神经管缺陷(NTD),血清及干血斑标本两种方法的筛查效果对比,差异无统计学意义(P>0.05)。结论干血斑法代替血清法行中孕期产前筛查的诊断效果较好,兰州市广泛采用干血斑法产前筛查的方法是可行的。

Objective To compare the consistency of dried blood spot assay and serum assay in prenatal screening during the second trimester of pregnancy,explore the screening effect,evaluate the feasibility,preliminarily establish a technical system of dried blood spot assay during the second trimester of pregnancy which is suitable for the region. Methods The serum and dried blood spot specimens of pregnant women meeting the inclusion criteria and receiving prenatal screening during the second trimester of pregnancy in Gansu Provincial Maternity and Child-care Hospital from June 2013 to June 2016 were collected,all the pregnant women were from Lanzhou,serological double test(AFP ＋Free β-hCG） and dried blood spot assay were performed at the same time. The pregnancy outcomes were followed up,the consistency,screening effects,and diagnostic value of the two methods were compared. Results A total of 18 459 cases were enrolled into this study,and 14 951 cases were followed up. There was no statistically significant difference in the screening effects of trisomy 21 syndrome,trisomy 18 syndrome,and neural tube defects between the two methods(P〉 0. 05）. Conclusion Compared with serum assay,the diagnostic effect of dried blood spot assay for prenatal screening during the second trimester of pregnancy is better,dried blood spot assay is feasible for widely prenatal screening in Lanzhou.