孕早、中期唐氏筛查血清学指标中位数本地化调整对筛查风险率的影响

Effect of Localization Adjustment of Median Serological Indicators of Down's Screening in First and Second Trimes⁃ter on Screening Risk Rate

目的:分析孕早、中期唐氏筛查血清学指标中位数本地化调整对筛查风险率的影响。方法:选取2017年1月—2020年12月在娄底市中心医院接受唐氏筛查的11269例孕妇血清学筛查数据进行中位数调整,应用于2021年1—12月在娄底市中心医院接受唐氏筛查的2806例孕妇孕早、中期血清学筛查中,比较调整前后的筛查效果。结果:调整前,各血清学指标中位数的倍数(MOM)偏离较大,调整后均趋近于1。孕早期调整前后,21-三体综合征高风险、临界风险阳性率比较,差异无统计学意义(P>0.05);调整后,18-三体综合征高风险、临界风险阳性率低于调整前,差异有统计学意义(P<0.05)。孕中期调整后,21-三体综合征高风险、临界风险阳性率低于调整前,差异有统计学意义(P<0.05);调整前后,18-三体综合征高风险、临界风险阳性率比较,差异无统计学意义(P>0.05)。调整前后,21-三体综合征假阳性率比较,差异无统计学意义(P>0.05)。结论:孕早、中期唐氏筛查血清学指标中位数本地化调整,可能有助于提高唐氏筛查效率。

Objective:To analyze the effect of localization adjustment of median serological indicators of Down's screening in the first and second trimester on the screening risk rate.Methods:Serological screening data of 11269 pregnant women who received Down's screening in Loudi Central Hospital from January 2017 to December 2020 were selected for median adjustment,and applied for serological screening of 2806 pregnant women in the first and second trimester who received Down's screening in Loudi Central Hospital from January 2021 to December 2021.The screening effect before and after adjustment was compared.Results:Before adjustment,the deviation of multiple of the median(MOM)of each serological indicator was large,and after adjustment,it was close to 1.In the first trimester,there was no significant difference in the positive rates of high risk and critical risk of trisomy 21 syndrome before and after adjustment(P>0.05).After adjustment,the positive rates of high risk and critical risk of trisomy 18 syndrome were lower than those before adjustment,and the difference was statistically significant(P<0.05).In the second trimester,the positive rates of high risk and critical risk of trisomy 21 syndrome after adjustment were lower than those before adjustment,and the difference was statistically significant(P<0.05).There was no significant difference in the positive rates of high risk and critical risk of trisomy 18 syndrome before and after adjustment(P>0.05).Before and after adjustment,there was no significant difference in the positive rate of trisomy 21 syndrome(P>0.05).Conclusion:The localization adjustment of the median serological indicators of Down's screening in the first and second trimester can help increase the efficiency of Down's screening.