孕中期血清学筛查在产前诊断及妊娠结局预测中的应用

发布时间：2018-05-31 23:47

本文选题：产前筛查 + 三体综合征　；参考：《南方医科大学学报》2015年07期

【摘要】：目的评价中孕期产前血清学筛查在产前诊断及妊娠结局预测中的应用价值。方法应用时间分辨荧光免疫法(DELFIA)对2011~2013年在我院产检的25 520例中孕期单胎妊娠孕妇进行free-β-HCG、μE3、AFP三联血清学指标检测,对筛查高风险者进行羊水穿刺产前诊断,对开放性神经管缺陷(NTD)高风险者进行多普勒超声检查确诊,并随访其妊娠结局。结果 25 520例产前筛查孕妇中,共筛出高风险1254例(4.91%),818例行介入性产前诊断者染色体结果异常共47例(5.75%)。随访结果显示筛查高风险人群不良妊娠结局发生率为1.91%(24/1254),显著高于筛查低风险人群的0.1%(25/24256),差异有统计学意义(P0.01)。产前诊断结果显示高龄组对21三体征的检出率(15%)显著高于35岁以下组(1.65%),差异有统计学意义(P0.01);另对189例因产前筛查单项指标中位数Mo M值异常行产前诊断的病例分析,染色体异常率为3.17%(6/189)。结论中孕期血清学筛查,除可筛查胎儿染色体及解剖结构异常,还可用于不良妊娠结局的指导,此外对高龄孕妇出生缺陷的预防也有较高的应用价值。产前筛查单指标Mo M值异常对胎儿染色体异常有一定的提示价值。
[Abstract]:Objective to evaluate the value of prenatal serological screening in prenatal diagnosis and pregnancy outcome prediction. Methods the serum free- 尾 -HCG, 渭 E3FP-AFP levels of 25,520 pregnant women with single pregnancy were detected by time-resolved fluorescence immunoassay (DELFIAA) in our hospital from 2011 to 2013, and prenatal diagnosis of amniocentesis was performed for screening high-risk women. Patients with high risk of NTD were diagnosed by Doppler ultrasound and their pregnancy outcome was followed up. Results among 25 520 pregnant women with prenatal screening, 1254 cases with high risk (4.91%) and 818 cases with interventional prenatal diagnosis had abnormal chromosome results in 47 cases (5.75%). The results of follow-up showed that the incidence of adverse pregnancy outcome was 1.91% / 1254% in high-risk population, which was significantly higher than that of 0.1% / 24256% in low risk group. The difference was statistically significant (P 0.01). The results of prenatal diagnosis showed that the detectable rate of 21 3 signs in the elderly group was significantly higher than that in the group under 35 years old, the difference was statistically significant (P 0.01), and the analysis of 189 cases of prenatal diagnosis due to the abnormality of the median Mo M value of the single index of prenatal screening, The chromosomal abnormality rate is 3.17 / 1899. Conclusion Serological screening during middle pregnancy can not only screen fetal chromosomes and anatomical abnormalities, but also be used to guide the adverse pregnancy outcome. It is also valuable for the prevention of birth defects in elderly pregnant women. The abnormality of Mo M value in prenatal screening has certain value for fetal chromosomal abnormality.
【作者单位】：南京医科大学附属无锡妇幼保健院产前诊断中心;
【基金】：江苏省妇幼保健重点资助项目(F201315) 无锡市科技局指令性项目(CSEYIN1109) 无锡市医管中心面上项目(YGZXM1510) 南京医科大学面上项目(2013NJMU200)
【分类号】：R714.5

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