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目的 探讨孕妇血清 β 绒毛膜促性腺激素 ( β HCG)在产前筛查非整倍体胎儿的最佳诊断界点。 方法 分析 1999年 5月至 2 0 0 2年 12月 36 30例孕妇血清 β HCG水平及其胎儿染色体核型 ,计算 β HCG不同诊断界点时筛查非整倍体胎儿的灵敏度及假阳性率。结果 18例中 11例非整倍体胎儿的母亲血清 β HCG水平高于正常孕妇 ( 6 1% ,11/ 18) ,为正常孕妇血清 β HCG中位数的 2 5 3倍 (MoM =2 5 3) ( P <0 0 5 )。单项 β HCG、单项孕妇年龄或 β HCG结合孕妇年龄进行筛查 ,以 β HCG结合孕妇年龄进行筛查的价值最高 ,单项 β HCG次之 ,单项孕妇年龄最低。以假阳性率 5 %为标准 ,β HCG的诊断界点为≥ 3 0 0MoM ,β HCG结合孕妇年龄进行筛查可检测出 5 0 %的非整倍体胎儿 ,单项 β HCG及单项孕妇年龄分别可检测出 4 5 %、34%的非整倍体胎儿。 结论 应用孕妇血清 β HCG筛查非整倍体胎儿 ,以 β HCG≥ 3 0 0MoM为诊断界点时诊断价值最高
Objective To explore the optimal diagnostic threshold of serum β-HCG in prenatal screening for aneuploid fetus. Methods The serum levels of β HCG and its fetal karyotype in 36 30 pregnant women from May 1999 to December 2002 were analyzed. The sensitivity and false positive rate of fetuses with aneuploidy in screening of β HCG were calculated . Results The serum levels of β HCG in 11 aneuploid fetuses were higher than that of normal pregnant women (61%, 11/18), which was 25.3 times higher than that of normal pregnant women (MoM = 25 3) (P <0 0 5). Individual β-HCG, single-age pregnant women or β-HCG combined with the age of pregnant women screening, β-HCG combined with the age of pregnant women screening the highest value, followed by a single β-HCG, the lowest single-age pregnant women. The false positive rate of 5% as the standard, β HCG diagnostic boundaries for ≥ 300MoM, β HCG combined with the age of pregnant women screening can detect 50% aneuploid fetus, individual β HCG and individual age of pregnant women respectively Can detect 45%, 34% of aneuploid fetuses. Conclusion Pregnancy serum β-HCG screening aneuploidy fetus, with β HCG ≥ 300MoM as the diagnostic value of the highest point of diagnosis