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目的:探讨早孕期3种唐氏综合征(Down syndrome,DS)筛查方案的筛查效能及成本效益分析。方法:回顾性分析39 289例参与早孕期DS筛查的孕妇资料,计算各DS筛查策略的检出率、假阳性率和阳性预测价值。通过“决策树”模型和成本效益分析,比较各筛查策略的经济学特性。结果:筛查方案中胎儿颈半透明度超声筛查(nuchal translucency,NT)和联合筛查的假阳性率稍低于血清筛查,筛查阳性进行产前诊断的接受度较高;3种筛查方案的效能:联合筛查>NT筛查>血清学筛查。成本效益分析示:血清学筛查的效益成本比值最高,具有一定的经济性。结论:3种方案中联合筛查的筛查功效最高,血清学筛查最具经济性。
Objective: To explore the screening efficacy and cost-benefit analysis of three Down Syndrome (DS) screening programs in early pregnancy. Methods: The data of 39 289 pregnant women participating in DS screening during early pregnancy were retrospectively analyzed. The detection rate, false positive rate and positive predictive value of each DS screening strategy were calculated. Through the “decision tree” model and cost-benefit analysis, comparing the economic characteristics of each screening strategy. Results: The false positive rate of fetal cervical translucentcy (NT) and combined screening was slightly lower than that of serum screening, and screening was positive for prenatal diagnosis. Three types of sieves Check program efficacy: Combined Screening> NT Screening> Serological Screening. Cost-benefit analysis shows: serological screening of the highest cost-benefit ratio, with a certain degree of economy. Conclusion: The three screening programs have the highest screening efficacy and the serological screening is the most economical.