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目的探讨孕早期颈项透明层(NT)厚度测量联合孕中期母体血清游离雌三醇、绒毛膜促性腺激素(β-h CG)和甲胎蛋白(AFP)检测在唐氏综合征产前筛查中的作用和意义。方法选择2012年2月~2014年6月在天津市滨海新区大港妇女儿童保健中心自愿接受产前唐氏综合征筛查的4 300例孕妇。分析孕妇产前的筛查结果、胎儿异常的发生情况以及唐氏综合征的筛查结果。结果 4 300例孕妇中,NT高危孕妇159例,阳性率为3.70%;经血清学检出的高危孕妇168例,阳性率为3.91%;上述两种检测方法均显示为高危的孕妇93例,阳性率为2.16%。将唐氏综合征的筛查结果分为A组(NT高危组)、B组(血清学检测为高危)、C组(两者均显示为高危组)和D组(A或B显示为高危组)。A、B两组的检测结果通过配对χ2检验差异无统计学意义(P>0.05),两种检验法的一致性K达0.55,即两种方法的检测结果是一致的;C组灵敏度下降,漏诊率上升,但特异度也上升,且阳性预测值最高;D组的灵敏度上升,漏诊率下降,但特异度也下降,且阳性预测值最低。结论胎儿NT测量在唐氏综合征产前筛查中具有重要意义。
Objective To investigate the relationship between NT thickness measurement and maternal serum free estriol, β-h CG and AFP in the first trimester of pregnancy in the screening of Down’s syndrome prenatal screening In the role and significance. Methods From February 2012 to June 2014, 4 300 pregnant women who volunteered to receive antenatal Down Syndrome screening in Dagang Women and Children’s Health Center, Binhai New Area, Tianjin City were selected. Analysis of prenatal screening results of pregnant women, fetal abnormalities and Down’s syndrome screening results. Results Of the 4 300 pregnant women, NT high-risk pregnant women were 159 cases, the positive rate was 3.70%. Serological high-risk pregnant women were 168 cases, the positive rate was 3.91%. The two detection methods showed 93 pregnant women with high risk, The positive rate was 2.16%. The Down’s syndrome screening results were divided into group A (NT high-risk group), group B (high-risk serology test), group C (both high risk group) and group D (A or B showed high risk group). There was no significant difference between the two groups (P> 0.05). The consistency of the two methods was 0.55, that is, the results of the two methods were consistent. The sensitivity of group C was decreased, The rate of misdiagnosis increased, but the specificity also increased, and the positive predictive value was the highest. In group D, the sensitivity increased, the misdiagnosis rate decreased, but the specificity decreased, and the positive predictive value was the lowest. Conclusion Fetal NT measurement is of great importance in prenatal screening of Down Syndrome.