孕中期血清学检测联合超声NT筛查在唐氏综合征诊断中的应用价值

The Clinical Application Value of Middle Pregnancy Serology Combined with NT Screening in Down’s Syndrome

目的分析在孕中期唐氏综合征(DS)检查中应用血清学指标联合超声检测胎儿颈项透明层(NT)的临床价值。方法选取本院2018年1月至2020年6月的就诊的17338例孕妇作为研究对象。入选孕妇在孕早期开展超声波检测NT,在孕中期进行母体血清甲胎蛋白(AFP)、游离人绒毛膜促性腺素亚基(freeβ-HCG)和游离雌三醇(uE3)的检测。运用风险评估软件分析孕中期血清学检测联合超声NT筛查在同一个体孕妇中对唐氏综合征诊断效能的影响。结果在17388例孕妇中,孕中期血清学检测出DS高危患者792例,确诊22例,患病率为0.13%,初筛阳性率为4.57%。孕中期的血清学检测检出率为63.64%,血清学联合NT筛查对DS检出率为81.82%,二者差异具有统计学意义(χ^(2)=6.23,P=0.03)。联合筛查的灵敏度和特异性均高于血清检测。结论孕中期血清学检测联合超声NT筛查对诊断DS具有较高的灵敏度和特异性,可以更加准确地预测孕妇的不良妊娠发生率,具有良好的临床应用价值。

Objective To analyze the application value of using serum pregnancy combined with NT in the screening of Down’s syndrome in early pregnancy.Methods We collected 17338 pregnant women who underwent these inspections in our hospital from January,2018 to December,2019 for the current study.The clinical values of serum AFP,Free-hCG,uE3 and NT were determined by fluorescence analyzer and ultrasound,respectively.We calculated serum screening risk,and serum combined NT screening,respectively,using the risk calculation software for the same person.The diagnostic value of each method alone or combined was then evaluated.Results In 17338 pregnant women,22 had a fetus with Down’s syndrome,with a rate of 0.13%.The positive rate of initial screening was 4.57%.The detection rates of DS in serum screening and combined screening were 63.64%and 81.82%,respectively,and the difference was statistically significant(χ^(2)=6.23,P=0.03).The sensitivity and specificity of combined detection were higher than serum screening.Conclusion In early pregnancy,a combined screening for DS has a higher sensitivity and specificity than serological screening,and it can effectively improve the detection rate,which can effectively reduce the number of pregnant women who need to receive invasive puncture and has a good clinical application value.