摘要
目的 探讨孕妇血清甲胎蛋白 (alpha fetoprotein,AFP)、绒毛膜促性腺激素β亚单位(human chorionic gonadotrop(h) in- beta subunit,β- h CG)、妊娠相关血浆蛋白 A(pregnancy- associat-ed plasma protein- A ,PAPP- A)联合筛查出生缺陷的临床价值。 方法 利用化学发光法测定孕妇血清 AFP、β- h CG,酶联免疫法测定血清 PAPP- A;B超确诊胎儿体格异常 ;羊水和或胎儿脐血确诊染色体、基因异常。 结果 1999年~ 2 0 0 0年筛查并全程追踪 5 98例孕妇 ,发现出生缺陷 37例 ,其中染色体异常 19例 (占 5 1.35 % ) ,染色体异常合并畸形 3例 (占 8.11% ) ,畸形 11例 (占 2 9.73% ) ,基因缺陷4例 (占 10 .81% )。 37例异常胎儿中治疗性引产 19例 ,自然流产 1例 ,异常胎儿产前阻断率为5 4.0 5 %。β- h CG>2 .4M、PAPP- A <0 .43M、AFP>2 .0 M、AFP<0 .6 M,筛查胎儿出生缺陷率分别为2 3.5 3%、19.0 5 %、12 .35 %、9.0 9% ,与β- h CG、AFP、PAPP- A正常值组筛查胎儿出生缺陷率 0 .5 5 %比较差异有显著性 (P<0 .0 0 5 )。 结论 孕妇血清 AFP、β- h CG、PAPP- A联合检测 ,不仅能筛查胎儿染色体数目和结构异常 。
Objective To examine the value of maternal serum β human chorionic gonadotrophin (β-hCG), pregnancy associated plasma protein A (PAPP-A) and alpha-fetoprotein(AFP) as predictor for screening birth deficiency. Methods The maternal serum β-hCG,PAPP-A and AFP of 598 pregnant women were measured at 6~35 weeks of gestation. All positive cases were ascertained by ultrasound, amniotic fluid or umbilical cord blood and followed up during the pregnancy. Results Thirty-seven cases of fetal abnormalities were found in 598 pregnant women. The positive rate of fetal abnormalities were 23.53%, 19.05%, 12.35% and 9.09% according to β-hCG>2.4M, PAPP-A<0.43M, AFP>2.0M and AFP<0.6M group respectively. The positive rate was higher in the abnormal screening group than that in the normal group (P<0.005). Conclusions The combined detection of AFP, β-hCG and PAPP-A in the serum of pregnant women can not only screen the abnormal number and the structure of the fetal chromosome, but also predict the gene dificiencies and visceral abnormalities of fetus.
出处
《中华围产医学杂志》
CAS
2002年第3期192-195,共4页
Chinese Journal of Perinatal Medicine
关键词
孕妇
血清
甲胎甲白
绒毛膜促性腺激素Β亚单位
妊娠相关血浆蛋白A
筛查
出生缺陷
alpha-Fetoproteins
Chorionic gonadotropin, beta subunit, human
Pregnancy-associated alpha-plasma protein
Abnormalities
Chromosome abnormalities