2616例孕中期孕妇的血清特异性标志物筛查结果分析

目的探讨孕中期产前筛查的临床应用价值，并探讨影响其风险值的主要因素。方法检测2616例孕中期（14～24周）孕妇血清中的甲胎蛋白（AFP）、人绒毛膜促性腺激素β亚单位（[3-HCG）和游离雌三醇（uE3）的浓度，其中AFP、β-HCG使用电化学发光法，uE3使用酶联免疫法检测；使用T21$SOFTw筛查软件评估风险。建议唐氏综合征或18-三体综合征高风险孕妇行胎儿羊水染色体核型分析，神经管缺陷高风险者接受高分辨超声检查。结果唐氏综合征、18-三体综合征、神经管缺陷高风险发生率分别为5．73％、0．34％、1．11％；高风险孕妇经产前诊断确诊唐氏综合征1例，神经管缺陷2例，其它染色体异常疾病3例。结论对孕中期孕妇进行产前筛查，是减少患染色体疾病和神经管缺陷患儿出生的有效方法；在筛查软件中应对诸多影响因素予以校正，而孕周的准确与否对筛查结果影响较大。

Screening specific serum biomarkers of 2616 pregnant women during the second trimester

Objective To evaluate the efficiency of screening specific biomarkers in the second-trimester pregnant women. Methods Serum levels ofAFP,β- HCG and uE3 were measured by CLIA or ELISA in 2616 pregnant women during 14~24 weeks, and the risk rate was analyzed with the T21 ＊ SOFTw program, the high-risk pregnant women were proposed to take fetal amniotic fluid or high resolution ultrasound examination. Results The high-risk rates for Down＇s syndrome, 18 - trisomy syndrome and neural tube defects were 5.73%, 0.34%, 1.11% respectively; there were one Down＇s syndrome and two neural tube defects, three other chromosomal abnormalities by prenatal diagnosis. Conclusion Screening analysis of second-trimester pregnancy serum is a major to prevent chromosomal disease and neural tube defects; the precise gestational age is the most important factor in the screening software.