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目的:分析中孕期母血清产前筛查指标,为加强产前筛查质量控制提供客观依据。方法 2015年5月到2017年6月在新疆生产建设兵团医院产科门诊检查的孕妇共1701例,孕周15~20周。采用Roche公司电化学发光分析仪e602、配套试剂测定AFP及βhCG,采用艾博罗软件对AFP/βhCG二联测定值及结合母龄、孕周、体重、是否双胎或多胎、有无糖尿病等相关因素计算唐氏综合征(DS)、18-三体、开放神经管缺陷(NTD)风险率。结果:筛查出DS高危风险孕妇22例,占1.3%;筛查出18-三体高危风险孕妇21例,占1.2%;筛查出NTD高危风险孕妇10例,占0.6%。高危风险孕妇集中在母龄25~35岁之间。孕妇体重在90~100kg和≥100kg时,AFP的MOM值中位数大于1.05,其他体重分组的AFP的MOM值中位数稳定在0.95~1.05之间;而βhCG除了90~100kg体重组外,其他体重组的MOM值中位数均小于0.95。AFP检测值中位数在19周和20周时与系统值比较存在较大的偏倚;βhCG检测值中位数在所有孕周与系统值比较均有较大偏倚。结论中孕期母血清学产前筛查是出生缺陷产前筛查的重要环节,应定期对产前筛查各项指标进行监测,不断改善软件的评估系统。
Objective: To analyze prenatal screening indicators of maternal serum in the second trimester to provide an objective basis for strengthening the quality control of prenatal screening. Methods From May 2015 to June 2017, 1701 pregnant women of obstetric and gynecological clinic in Xinjiang Production and Construction Corps Hospital were enrolled. The gestational age ranged from 15 to 20 weeks. Using Roche electrochemical chemiluminescence analyzer e602, supporting reagents for the determination of AFP and βhCG, using the Aibo Luo software AFP / βhCG dual measured values and combined with age, gestational age, body weight, whether twins or multiple births, with or without diabetes, etc. Related factors were calculated Down Syndrome (DS), 18-trisomy, open neural tube defects (NTD) risk. Results: 22 pregnant women with high-risk DS were screened out, accounting for 1.3%. Twenty-one pregnant women at risk of 18-trisomy 18 were screened out, accounting for 1.2%. Ten pregnant women at risk for screening NTD were found, accounting for 0.6%. High risk pregnant women are concentrated in the mother of 25 to 35 years old. The median MOM of AFP was more than 1.05 when the body weight of pregnant women was 90 ~ 100kg and ≥100kg, and the median MOM of AFP was 0.95 ~ 1.05 in other body weight groups. The median of AFP of βhCG was 90 ~ 100kg, The median MOM values for other weight groups were less than 0.95. The median AFP test values at 19 and 20 weeks compared with the system values there is a greater bias; median βhCG test in all gestational weeks compared with the system values are more biased. Conclusion Prenatal screening of maternal serology in the second trimester is an important part of prenatal screening for birth defects. The indicators of prenatal screening should be regularly monitored to improve the software evaluation system.