17666例孕中期母血清学筛查的质量分析

Quality analysis of 17 666 cases of second trimester maternal serological screening

目的探讨孕中期母血清唐氏四联筛查的质量控制。方法采集孕中期母血清,采用贝克曼Access2微粒子化学发光分析仪检测母血清中甲胎蛋白(AFP)、总β-人绒毛膜促性腺激素(β-HCG)、游离雌三醇(u-E3),抑制素A(Inh A);结合年龄、孕周、体重等采用上海腾程唐氏筛查软件计算风险度。根据风险度、中位数倍数(MOM)值、室内质控结果、申请单填写、标本的保存回顾分析唐氏四联筛查的质量控制。结果唐氏筛查阳性率与年龄呈正相关(P<0.01),最佳筛查孕周15周5天~20周0天,全血标本静止放置于2~8℃可保存7天。结论全面质量控制在孕中期四联筛查检测中具有重要价值,可保证风险度的准确性。低风险中风险等级划分可提示孕妇漏筛的可能危险程度,进一步降低患儿的出生。

Obstract：To investigate quality control of second trimester maternal serum Down′s quadruple screening. Methods：After second trimester maternal serum is collected,the BECKMAN Access2 microparticle chemiluminiscence analyzer is used to detect alpha fetoprotein（AFP）,total beta human chorionic gonadotropin（β-HCG）,free female three alcohol（u-E3）and inhibin A（Inh A）in the maternal serum,and lastly risk degree is calculated by Shanghai Teng Cheng Down＇s screening software combined with age,gestational age,body weight,etcetera. According to the risk degree,multiple of median（MOM）value,results of internal quality control,application form and preservation of specimen,the quality control of Down＇s quadruple screening is analyzed retrospectively. Results：The positive rate of Down＇s screening is positively correlated with age（P〈0.01）. The best gestational age for screening is from 5 days after 15 th week to 20 th week. And whole blood sample which is put still in 2～8 degrees can be preserved for 7 days. Conclusion：Total quality control has important value in second trimester quadruple screening detection,and accuracy of risk degree can be guaranteed. Low and high risk rank can hint possible risk level of leakage screen of of pregnant women,and the birth of sick children can be further lowered.