双顶径估计孕龄对孕中期唐氏综合征筛查效果的影响

发布时间：2018-04-16 11:17

本文选题：双顶径 + 孕龄估计　；参考：《中国医科大学学报》2015年12期

【摘要】：目的评价国内6个标准的双顶径与孕龄对照表对唐氏综合征筛查整体效果的影响和对孕妇个体风险率变化的影响。方法采用6种双顶径与孕龄对照表估计25 346例孕12~20周孕妇的孕龄,孕龄计算精确到天,计算6种对照表的产前筛查风险值,通过受试者工作特征曲线(ROC)曲线下面积、检出率、假阳性率来评价不同对照表对筛查的影响;通过个体风险率的变化来评价孕龄偏差对孕妇个体的影响。结果 ROC曲线下面积最高为自建对照表(0.972),最低为上海某医院对照表(0.923),二者间差异有统计学意义(P=0.045)。在同样75%检出率条件下,假阳性率最低为自建对照表(2.3%),截断值为1∶280;最高为《中华妇产科学》对照表(4.8%),截断值为1∶345。对于孕妇个体风险值,估计的孕龄比真实值偏大,风险将人为的变大,假阳性的风险增大;估计的孕龄比真实值偏小,风险将人为的变小,假阴性的风险增大。结论 6种对照表对唐氏综合征的筛查有不同的影响,自建对照表估计孕龄筛查效果最好,香港对照表估计孕龄筛查效果第二,不真实的孕龄估计对孕妇个体风险值有较大的影响。
[Abstract]:Objective to evaluate the effect of six standard diameters of parietal diameter and gestational age on the overall screening effect of Down's syndrome and the change of individual risk rate of pregnant women.Methods the gestational age of 25 346 pregnant women at 1220 weeks was estimated by using six kinds of biparietal diameters and gestational age comparison tables. The pregnancy age was calculated accurately to the day, and the prenatal screening risk values were calculated. The area under the ROC curve was calculated by the operating characteristic curve of the subjects and the detectable rate was detected.The false positive rate was used to evaluate the influence of different comparison tables on screening, and the influence of pregnancy age deviation on pregnant women was evaluated by the change of individual risk rate.Results the area under the ROC curve was the highest in the self-made control table 0.972 and the lowest in a hospital in Shanghai 0.923. The difference between the two was statistically significant.Under the condition of the same 75% positive rate, the lowest false positive rate was the self-made control table 2.30.The truncation value was 1: 280, and the highest was 4.8and the truncation value was 1: 345in the "Chinese obstetrics and gynecology" control table.For the individual risk value of pregnant women, the estimated gestational age is larger than the true value, the risk will increase artificially, the risk of false positive will increase, the estimated gestational age will be smaller than the true value, the risk will be artificially small, the risk of false negative will increase.Conclusion there are different effects on the screening of Down's syndrome by six kinds of comparison tables. The self-made comparison table has the best effect in estimating the gestational age, and the Hong Kong comparison table is the second in estimating the screening effect of gestational age.The unreal estimation of gestational age has great influence on the individual risk value of pregnant women.
【作者单位】：宁波大学医学院预防医学研究所;宁波市妇女儿童医院产前筛查诊断中心;
【基金】：国家自然科学基金(31301084) 宁波自然科学基金(2013A610226) 宁波大学王宽诚教育基金项目
【分类号】：R714.5

【相似文献】