产前筛查及数据微机分析的临床意义

目的应用孕妇血清妊娠蛋白检测产前筛查胎儿质量。方法通过ELISA方法检测8790例、孕龄为14-20周的中国人群孕妇血清AFP、βhCG浓度,结合孕妇年龄、孕周等关键参数,计算唐氏综合征的风险系数,并建立了适合本中心的孕中期MoM值。结果在14～20孕周的AFP血清浓度为（28.13～72.50）IU/ml、Free-βhCG血清浓度为9.22mIU/ml-47.09mIU/ml,且呈正态分布,各孕周中位数值与本中心使用的贝喜唐氏综合征产前筛查系统的中位数值较一致,但与以往报道的白种人、黑种人数据有明显的差异。用贝喜唐氏综合征产前筛查系统计算,临床筛查假阳性率约为5.95%;对高危人群中的459人次进行了羊水诊断,其中有唐氏综合征患儿1例,神经管缺损10例。结论在中国人群AFP和βhCG数据库基础上建立的唐氏综合征筛查系统,对于年均有2000万新生儿的中国有着更重要的价值。

Clinical significance of the prenatal screening and computer analysis of the data

Objective：Test quality of prenatal screening through detection of pregnancy serum protein.Methods：Serum Beta-HCG and AFP of 8790 Chinese women were measured at 14～20 weeks of gestation by ELISA,then the risk of the fetus of Down syndrome were calculated with the combination of maternal age,gestation age and other key parameters.The second trimester MoM value of our center was established.Results：At 14～20 weeks of gestation,the concentration of serum AFP of Chinese women was 28.13～72.50 IU/ml while that of Serum Beta-HCG was 9.22 mIU/ml-47.09 mIU/ml.Both of them were in Normal Distribution.The median for each week of gestation is consistent with the median of（Beixi）prenatal screening system which is used in our center,and significantly different from the data of previous reports of white people or black people.The false positive rate of Down＇s syndrome by（Beixi） system was about 5.95%clinically.After the amniocentesis of 459 high-risk cases,1 case of Down syndrome and 10 cases of neural tube defects had been detected.Conclusion：It is of more important value and significance to establish the Down＇s syndrome screening system based on the database of AFP and beta-HCG for Chinese crowd which has an average of 20 million newborns each year.