江西省中北部地区孕中期唐氏综合征筛查血清标志物中位数的构建

发布时间：2018-03-30 03:14

本文选题：江西省　切入点：产前筛查　出处：《中南大学学报(医学版)》2017年07期

【摘要】：目的:建立江西省中北部地区孕中期唐氏综合征(Down’s syndrome,DS)产前筛查血清学标志物中位数数据库。方法:采用时间分辨免疫荧光法对57 548例孕15~20+6周孕妇进行甲胎蛋白(AFP)、游离绒毛膜促性腺激素(β-hCG)和游离雌三醇(uE3)血清学三联筛查,应用LifeCycle 4.0软件进行风险评估。使用SAS 9.2软件进行模型筛选,构建江西省中北部地区孕中期DS筛查人群中位数拟合方程,采用新构建的中位数系统重新评估人群患DS风险,并评估其适用性。结果:江西省中北部地区中位数与内置中位数分布不同,差异有统计学意义(Z=2.201,P=0.028),经模型筛选,三联指标中位数与孕龄的关系采用加权回归模型拟合,三联指标中位数倍数(Mo M值)与体重的关系采用倒数模型,拟合效果好;新构建的中位数系统较内置系统检出率由62.75%提高到72.55%,假阳性率由5.84%降低至4.94%。结论:新构建的江西省中北部地区孕中期中位数系统适用于本地区筛查,各地区应建立自己的血清标志物中位数系统以提高筛查效率。
[Abstract]:Objective: to establish a median database of serological markers for prenatal screening of Down's syndrome syndrome (Downs syndrome DSs) in central and northern areas of Jiangxi Province. Methods: a total of 57,548 pregnant women of 1520 weeks gestation were treated with alpha-fetoprotein by time-resolved immunofluorescence. Serological screening of free chorionic gonadotropin (尾 -hCGG) and free estriol triglyceride (E3). LifeCycle 4.0 software was used to evaluate the risk, SAS 9.2 software was used to screen the model, the median fitting equation of DS screening population in the middle and northern regions of Jiangxi Province was constructed, and the newly constructed median system was used to re-evaluate the population risk of DS. Results: the distribution of median and built-in median in central and northern Jiangxi Province was different, and the difference was statistically significant. The relationship between median and gestational age was fitted by weighted regression model. The reciprocal model was used for the relationship between the median multiple and the weight of the triple index, and the fitting effect was good. The detection rate of the newly constructed median system was increased from 62.75% to 72.55%, and the false positive rate was decreased from 5.84% to 4.94. Conclusion: the newly constructed median system of middle pregnancy in central and northern Jiangxi Province is suitable for screening in this area. Each region should establish its own median serum marker system to improve the screening efficiency.
【作者单位】：江西省妇幼保健院产前诊断中心;
【基金】：江西省科技厅重大项目(S-27-A)~~
【分类号】：R714.5

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