摘要
目的研究高龄孕妇(≥35岁)血清学筛查唐氏综合征的价值,以期减少羊膜腔穿刺的几率,避免医源性流产。方法对在复旦大学附属妇产科医院产检的10601名中期妊娠孕妇进行唐氏综合征的血清学筛查,采用血清学三联指标,即绒毛膜促性腺激素、非结合雌三醇、甲胎蛋白。通过Beckman公司的放射免疫仪测定计算上述三项指标的MoM值和唐氏综合征的患病风险。以1/380为切割值,并随访所有孕妇的妊娠结局。结果从2007年6月～2009年12月,共有10601名在复旦大学附属妇产科医院产检的适龄孕妇进行唐氏综合征的血清学筛查,高风险孕妇有899例,总的阳性率为8.48%。其中高龄孕妇有777例,其高风险例数有268例,阳性率为34.49%,明显高于年龄低于35岁的阳性风险率,后者为6.42%。在随访结果中,共有9例唐氏儿,其中4例为高龄孕妇所生。这4例唐氏综合征的血清学检查结果均为高风险,高龄孕妇的血清学筛查阴性结果中,没有出现唐氏儿。结论对于高龄孕妇,血清学筛查可作为第一线筛查手段,应与孕妇及家属探讨产前筛查的方法及各自利弊,由孕妇及家属决定是否直接接受羊膜腔穿刺。
Objective We aim at studing the value of maternal serum screening(MSS)of Down's syndrome for women with advanced maternal age(AMA,≥35 years),and try to lessen the rate of amniocentesis.Methods 10 601 cases in second trimester of MSS for Down's syndrome have been done in our hospital from June 1st,2007 to the end of 2009,which used three markers of HCG,uE3,and AFP,by Beckman Coulter,Access Immunoassay system.The cut off point is 1/380,and positive results was considered when MSS below it.All cases were followed to have outcome of pregnancy.Results Among the 10601 cases of MSS,899 cases have positive results,in which 268 positive results belong to 777 cases of AMA.The total positive MSS rate of Down's is 8.48%,and AMA incidence rate is 7.33% with positive MSS rate of 34.49%.The positive MSS rate of Down's in age below 35 years old group(6.42%)is significantly lower than that in the AMA group.However,only four cases in total nine of trisomy 21 are AMA,whose MSS results are all positive.There is no trisomy 21 in AMA group with negative results of MSS.Conclusion MSS may be the first line of examination to avoid the birth of trisomy 21 fetus for AMA pregnant women.Because amniocentesis is of invasive,for the safe of fetus and mother,there is no necessary to ask all AMA pregnant women to have amniocentesis and chromosome analysis.
出处
《中国产前诊断杂志（电子版）》
2010年第4期9-11,共3页
Chinese Journal of Prenatal Diagnosis(Electronic Version)
关键词
高龄孕妇
唐氏综合征
血清学筛查
advanced maternal age,Down's syndrome,maternal serum screening
