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目的探讨用干血片和血清行孕中期唐氏筛查两方案筛查结果的一致性并比较两种方法的筛查效率。方法收集2011年4月至2011年9月于我院接受孕中期(孕15w 0d至20w 6d)唐氏筛查孕妇2203例血清及干血片行甲胎蛋白和游离促绒毛膜激素β亚基测定,评估T21、T18、开放性神经管缺陷风险,并追踪随访妊娠结局。结果干血片与血清法对唐氏综合征筛查阳性率为5.63%和7.85%,检出率为33.3%和66.7%,假阳性率为5.59%和7.77%,阳性预测值为0.81%和1.16%,灵敏度为33.35he 66.7%,特异度为94.41%和92.23%。干血片法与血清法进行孕中期唐氏筛查21三体、18三体和开放性神经管缺陷结果一致性检验Kappa值分别为0.622、0.331和0.415。结论干血片对唐氏综合征、开放性神经管缺陷筛查结果一致性中等(0.4≤Kappa≤0.8),18三体筛查结果一致性不理想(Kappa=0.331)干血片用于孕中期唐氏筛查有一定可行性,为提高筛查效率应扩大样本量进一步研究。
Objective To investigate the consistency of screening results between two programs in the second trimester of Down’s syndrome with dry blood serum and serum and to compare the screening efficiency of the two methods. Methods A total of 2203 pregnant women, who underwent Down’s screening (pregnant 15w 0d to 20w 6d) in our hospital from April 2011 to September 2011, were collected for serum alpha-fetoprotein and free progesterone-β subunit Measurements, assessment of T21, T18, open neural tube defects risk, and follow-up of pregnancy outcomes. Results The positive rate of Down syndrome was 5.63% and 7.85% respectively with the detection rate of 33.3% and 66.7%, the false positive rate was 5.59% and 7.77%, the positive predictive value was 0.81% 1.16%, the sensitivity was 33.35he 66.7%, the specificity was 94.41% and 92.23%. Dry blood chip method and serum method for the second trimester Down’s screening 21 Trisomy, 18 trisomy and open neural tube defects consistency test Kappa values were 0.622,0.331 and 0.415. Conclusion The results of Qianxue Tablet on Down’s syndrome and open neural tube defects were consistent (0.4≤Kappa≤0.8), and the results of Trisomy 1818 were not consistent (Kappa = 0.331) Mid-term Down’s screening has a certain feasibility, in order to improve screening efficiency should be expanded sample size for further study.