无锡地区孕早期产前筛查指标中位数的建立及临床意义

发布时间：2019-01-13 06:55

【摘要】：目的建立无锡地区孕早期筛查血清学指标游离β-人绒毛膜促性腺激素(freeβ-HCG),妊娠相关蛋白A(PAPP-A)在不同孕周的中位数值,探讨孕早期筛查指标中位数方程的本地化调整对筛查效率的影响。方法采用时间分辨免疫荧光(TRFIA)技术和Life Cycle 4.0软件对无锡地区5 294例孕9~13(~(+6))周单胎孕妇进行血清游离β-HCG、PAPP-A浓度测定并计算筛查风险,应用统计软件分析两项血清学指标的中位数,建立本地区孕妇各孕周的游离β-HCG、PAPP-A中位数的回归方程,再经体重校正得到新的中位数,对产筛数据重新作风险评估,结合产前诊断核型分析结果及随访的孕妇妊娠结局,比较中位数校正前后的筛查效果。结果与软件内嵌值比较,本地孕妇孕早期血清学指标经孕周及体重校准后的中位数值普遍偏高(游离β-HCG:P0.05;PPAPP-A:P0.05)。采用本地与内嵌软件两组中位数分别计算筛查风险,两者对21三体的检出率分别为85.7%和71.4%;假阳性率分别为4.59%和4.74%。结论中位数参数存在种族与地域差异,建立本地区孕早期人群产前筛查血清标志物中位数方程并进行体重校正非常重要,校正后的本地化中位数能提高产前筛查的筛查效率。
[Abstract]:Objective to establish the median value of free 尾-human chorionic gonadotropin (free 尾-HCG), pregnancy-associated protein A (PAPP-A) in different gestational weeks) for early pregnancy screening in Wuxi area. To investigate the effect of local adjustment of median equation of screening index in early pregnancy on screening efficiency. Methods using time-resolved immunofluorescence (TRFIA) technique and Life Cycle 4.0 software, the serum free 尾-HCG,PAPP-A levels were measured in 5 294 pregnant women with single pregnancy at the age of 9 ~ (13) weeks in Wuxi area and the screening risk was calculated. The median of two serological indexes was analyzed by statistical software, and the regression equation of free 尾-HCG,PAPP-A was established for pregnant women in this area. The new median was obtained by body weight correction, and the risk assessment of the screening data was made. The results of prenatal diagnosis karyotype analysis and pregnancy outcome were compared before and after median correction. Results compared with the software embedded values, the median values of serum markers of local pregnant women after gestational week and body weight calibration were generally higher (free 尾-HCG:P0.05;PPAPP-A:P0.05). The median of local and embedded software was used to calculate the screening risk. The detection rate of trisomy 21 was 85.7% and 71.4%, and the false positive rate was 4.59% and 4.74%, respectively. Conclusion there are ethnic and regional differences in the median parameters. It is very important to establish the median equation of serum markers for prenatal screening in early pregnancy population and to correct the body weight. The local median after correction can improve the screening efficiency of prenatal screening.
【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】：无锡市医管中心面上项目(No:YGZXM1510) 无锡市科技发展基金项目(No:CSE31N1511) 江苏省妇幼保健重点资助项目(No:F201315)
【分类号】：R714.5

【相似文献】