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目的比较早孕期、中孕期及早中孕期联合血清学筛查唐氏综合征策略,探索更加适用于临床的血清学筛查策略。方法对2014年3月-2015年11月来我院建档产检的110例早孕期孕妇进行胎儿的颈后透明层(nuchal translucency,NT)超声测量、早孕期及中孕期血清学标记物浓度检测,分别按照早孕一站式、中孕期血清学三联筛查及早中孕期联合筛查的策略进行风险评估。对92例资料完整的病例进行筛查高风险率的一致性检验。结果总的早孕期高风险率为10.9%(12/110);中孕期高风险率为9.8%(9/92);早中孕期联合评估高风险率为5.4%(5/92)。早中孕联合筛查的高风率较低,与早孕期一站式筛查、中孕期血清学三联筛查比较差异有统计学意义(χ~2=29.54,P<0.05;χ~2=20.65,P<0.05)。结论早中孕联合筛查对于降低筛查的高风险率,提高产前筛查的临床效率,减少进一步有创产前诊断的病例数量具有重要意义。
Objective To compare serological screening of Down’s syndrome in early pregnancy, middle-pregnancy, early-middle and early pregnancy, and to explore a more suitable serological screening strategy for clinical use. Methods A total of 110 pregnant women with early pregnancy who were filing for medical examination in our hospital from March 2014 to November 2015 were enrolled in the ultrasound examination of the nuchal translucency (NT) of the fetus and the serological marker concentrations in the first trimester and the second trimester , Respectively, in accordance with one-stop early pregnancy, triple pregnancy screening and early pregnancy screening strategy for risk assessment. Ninety-two patients with complete data were screened for high-risk consistency tests. Results The overall high risk of early pregnancy was 10.9% (12/110). The high risk of pregnancy was 9.8% (9/92). The high risk of early pregnancy was 5.4% (5/92). There was a significant difference in serological triple screening during early pregnancy (χ ~ 2 = 29.54, P <0.05; χ ~ 2 = 20.65, P <0.05). Conclusion Combined screening of early pregnancy and pregnancy is of great significance for reducing the high risk of screening, improving the clinical efficiency of prenatal screening and reducing the number of cases with further invasive prenatal diagnosis.