孕中期血清学、超声检查在胎儿染色体异常筛查中的应用

发布时间：2019-06-05 14:59

【摘要】：目的观察孕中期血清学、超声检查在胎儿染色体异常筛查中的应用效果。方法采用化学发光法测定38 165例单胎孕妇血清中甲胎蛋白、游离人绒毛膜促性腺激素和(或)游离雌三醇浓度,利用随机配载软件计算胎儿21-三体、18-三体和神经管畸形风险值;采用系统超声检查孕中期的10 727例孕妇。血清学提示高风险胎儿者及系统超声检查提示胎儿结构异常者行羊膜腔穿刺羊水细胞培养核型分析。结果血清学检查异常核型检出率为4.0%(69/1 708)。超声检查对各种先天结构异常检出率为2.2%(236/10 727),异常核型检出率为28.8%(49/170)。超声检查胎儿异常核型检出率高于血清学检查(P0.01)。血清学或超声检查之一异常并接受羊膜腔穿刺者1 819例,其中异常核型者103例,阳性率为5.7%。血清学、超声检查均异常者59例,其中异常核型检出率为25.4%(15/59),高于单一血清学检查(P0.01),但与单一超声检查比较无统计学差异。结论孕中期血清学检查胎儿染色体异常假阳性率高,超声检查胎儿染色体检出率高于血清学检查。以血清学检查为基础,联合超声检查,可以提高产前胎儿染色体异常筛查准确率。
[Abstract]:Objective to observe the effect of serology and ultrasound in the screening of fetal chromosome abnormalities in the second trimester of pregnancy. Methods the concentrations of alpha-fetoprotein, free human chorionic gonadotropin and / or free estriol in serum of 38165 single pregnant women were determined by chemiluminescence method. Fetal 21-trisomy was calculated by random loading software. 18-trisomy and neural tube malformation risk value; 10727 pregnant women in the second trimester of pregnancy were examined by systematic ultrasound. Serological analysis of amniotic fluid cell culture karyotype was performed in patients with high risk fetuses and those with abnormal fetal structure. Results the detection rate of abnormal karyotype in serological examination was 4.0% (69 鈮，

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