产前超声联合血清学检测在21-三体综合征中的筛查与诊断价值

The value of prenatal ultrasound combined with serological detection in screening and diagnosis of trisomy 21 syndrome

目的探究产前超声联合血清学检测在21-三体综合征中的筛查与诊断价值。方法选取2018年6月至2020年6月于本院产检的1500名孕妇作为研究对象,所有产妇均接受产前超声检查和血清学检测,结果显示高风险孕妇建议行羊水穿刺染色体筛查确诊,若不接受羊水染色体筛查者以引产、流产或生产后胎儿结果为标准。分析产前超声、血清学检测及产前超声联合血清学检测对21-三体综合征的诊断价值。结果1500名孕妇经羊水穿刺染色体筛查或引产、流产、生产后结果共检出21-三体综合征207例,产前超声检出142例,血清学检测检出183例,产前超声联合血清学检测检出198例。产前超声、血清学检测及产前超声联合血清学检测的AUC分别为0.843、0.942、0.978。产前超声联合血清学检测诊断的灵敏度为95.65%,明显高于产前超声检查、血清学检测的68.60%、88.41%,假阴性率为4.35%,低于产前超声检查、血清学检测的31.40%、11.59%,差异有统计学意义(P<0.05)。结论产前超声联合血清学检测在产前21-三体综合征筛查中具有较高的诊断价值,可提高新生儿出生质量。

Objective To explore the value of prenatal ultrasound combined with serological detection in screening and diagnosis of trisomy 21 syndrome.Methods 1500 pregnant women who were examined in our hospital from June 2018 to June 2020 were selected as the study subjects,all the pregnant women underwent prenatal ultrasound and serological tests,the results showed that high-risk pregnant women were recommended to un-dergo amniocentesis chromosome screening for diagnosis,if they did not undergo amniocentesis chromosome screening,the results of induced labor,abortion or post-natal fetus were taken as the criteria.To analyze the diagnostic value of prenatal ultrasound,serological test and prenatal ultrasound combined with serological test for trisomy 21 syndrome.Results Among 1500 pregnant women,207 cases of trisomy 21 syndrome were detected by amniocentesis chromosome screening or induced labor,abortion,and postnatal results,142 cases were detected by prenatal ultrasound,183 cases were detected by serological test,and 198 cases were detected by prenatal ultrasound combined with serological test.The AUC of prenatal ultra-sound,serological detection and prenatal ultrasound combined with serological detection were 0.843,0.942 and 0.978,respectively.The diagnostic sensitivity of prenatal ultrasound combined with sserological detection was 95.65%,which was significantly higher than 68.60%and 88.41%of pre-natal ultrasonography and serological detection,and the false negative rate was 4.35%,which was lower than 31.40%and 11.59%of prenatal ultraso-nography and serological detection,the difference was statistically significant(P<0.05).Conclusion Prenatal ultrasound combined with serological screening has high diagnostic value in prenatal screening of trisomy 21 syndrome.