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目的:建立一套产前筛查程序,探讨影响其风险值的主要因素。方法:采用化学发光法对1048例孕(14～21)周孕妇血清中的AFP、游离β-HCG和非耦合雌三醇(uE3)进行检测,通过“筛查软件”计算风险率,对高危孕妇取羊水或脐血行染色体核型分析。结果:共筛查出Down’s综合征、开放性脊柱裂OSB、18-三体综合征高风险孕妇77例,阳性率7.3%。其中31例经胎儿染色体检查,发现3例异常妊娠,1例假阴性,暂无有缺陷的胎儿出生。有5例初筛阳性的孕妇进行二次抽血检测,但风险值相差较大。结论:不建议对初筛阳性的结果进行二次抽血检测;在筛查软件中应对诸多影响因素予以校正,而孕周的准确与否至关重要。
Objective: To establish a set of prenatal screening procedures to explore the main factors affecting the risk value. Methods: The serum levels of AFP, free β-HCG and non-conjugated estriol (uE3) in 1048 pregnancies (14-21 weeks) pregnant women were detected by chemiluminescence method. The risk was calculated by “screening software” Pregnant women take amniotic fluid or cord blood chromosomes karyotype analysis. Results: A total of 77 pregnant women with Down’s syndrome, open spina bifida OSB and 18-trisomy syndrome were selected. The positive rate was 7.3%. 31 cases of fetal chromosomal examination, found that 3 cases of abnormal pregnancy, 1 case of false-negative, no defect in the fetus. There are 5 cases of pregnant women screening positive second blood test, but the risk difference between the larger. CONCLUSIONS: It is not advisable to perform secondary blood tests for positive screening results. Many factors should be corrected in the screening software, and the accuracy of gestational age is of crucial importance.