sHLA-G联合孕中期唐氏筛查对21和18三体胎儿检出率的影响

Effect of sHLA-G combined with Down's syndrome screening on the detection rate of trisomy 21 and 18 fetuses in the second trimester

目的探讨人可溶性白细胞抗原G(sHLA-G)联合孕中期唐氏筛查对21和18三体胎儿检出率的影响。方法回顾性分析1019例行孕中期唐氏筛查孕妇的孕期数据及分娩后胎儿情况。其中,464例孕妇唐氏筛查高风险,219例胎儿超声软指标异常或新生儿异常,336例唐氏筛查低风险。分娩后,139例为21号染色体三体胎儿,83例为18号染色体三体胎儿,797例为正常胎儿。检测孕妇孕中期血清sHLA-G、甲胎蛋白(AFP)、游离人绒毛膜促性腺激素β亚基(Free-β-hCG)和游离雌三醇(uE3)水平。比较在相同假阳性率条件下三联法(AFP、Free-β-hCG和uE3)和四联法(sHLA-G、AFP、Free-β-hCG和uE3)对21和18三体胎儿的检出率。结果在相同假阳性率条件下,三联法对21和18三体胎儿的检出率分别为75.54%和74.70%,四联法对21和18三体胎儿的检出率分别为81.29%和96.38%;四联法对18三体胎儿的检出率高于三联法(P<0.01),对21三体胎儿的检出率稍高于三联法(P>0.05)。结论sHLA-G联合孕中期唐氏筛查能提高21和18三体胎儿的检出率。

Objective To study the effect of soluble human leukocyte antigen G(sHLA-G)combined with Down's syndrome screening on the detection rate of trisomy 21 and 18 fetuses in the second trimester.Methods The pregnancy data and fetal condition after delivery of 1019 pregnant women undergoing Down's syndrome screening in the second trimester were retrospectively analyzed.There were 464 fetuses with high-risk,219 cases with ultrasound abnormality during pregnancy or neonatal abnormality,and 336 fetuses with low-risk.After delivery,there were 139 trisomy 21 fetuses,83 trisomy 18 fetuses,and 797 normal fetuses.The serum levels of sHLA-G,α-fetoprotein(AFP),freeβsubunit human chorionic gonadotropin(Free-β-hCG)and unconjugated-estriol(uE_3)in the pregnant women were detected.The detection rate of trisomy 18 fetuses and trisomy 21 fetuses was compared between quadruple screening(sHLA-G,AFP,Free-β-hCG and uE_3)and triple screening(AFP,Free-β-hCG and uE_3)under the same false positive rate.Results Under the same false positive rate,the detection rates of trisomy 21 and trisomy 18 fetuses in triple screening were 75.54%and 74.70%respectively,which in quadruple screening were 81.29%and 96.38%respectively.The detection rate of quadruple screening for fetuses with trisomy 18 was higher than that of triple screening(P<0.01),which for fetuses with trisomy 21 was slightly higher than that of triple screening(P>0.05).Conclusion sHLA-G combined with Down's syndrome screening in the second trimester can improve the detection rate of trisomy 21 and 18 fetuses.