本文選題：產(chǎn)前篩查 + 三體綜合征��； 參考：《南方醫(yī)科大學(xué)學(xué)報》2015年07期

【摘要】：目的評價中孕期產(chǎn)前血清學(xué)篩查在產(chǎn)前診斷及妊娠結(jié)局預(yù)測中的應(yīng)用價值。方法應(yīng)用時間分辨熒光免疫法(DELFIA)對2011~2013年在我院產(chǎn)檢的25 520例中孕期單胎妊娠孕婦進行free-β-HCG、μE3、AFP三聯(lián)血清學(xué)指標(biāo)檢測,對篩查高風(fēng)險者進行羊水穿刺產(chǎn)前診斷,對開放性神經(jīng)管缺陷(NTD)高風(fēng)險者進行多普勒超聲檢查確診,并隨訪其妊娠結(jié)局。結(jié)果 25 520例產(chǎn)前篩查孕婦中,共篩出高風(fēng)險1254例(4.91%),818例行介入性產(chǎn)前診斷者染色體結(jié)果異常共47例(5.75%)。隨訪結(jié)果顯示篩查高風(fēng)險人群不良妊娠結(jié)局發(fā)生率為1.91%(24/1254),顯著高于篩查低風(fēng)險人群的0.1%(25/24256),差異有統(tǒng)計學(xué)意義(P0.01)。產(chǎn)前診斷結(jié)果顯示高齡組對21三體征的檢出率(15%)顯著高于35歲以下組(1.65%),差異有統(tǒng)計學(xué)意義(P0.01);另對189例因產(chǎn)前篩查單項指標(biāo)中位數(shù)Mo M值異常行產(chǎn)前診斷的病例分析,染色體異常率為3.17%(6/189)。結(jié)論中孕期血清學(xué)篩查,除可篩查胎兒染色體及解剖結(jié)構(gòu)異常,還可用于不良妊娠結(jié)局的指導(dǎo),此外對高齡孕婦出生缺陷的預(yù)防也有較高的應(yīng)用價值。產(chǎn)前篩查單指標(biāo)Mo M值異常對胎兒染色體異常有一定的提示價值。
[Abstract]:Objective to evaluate the value of prenatal serological screening in prenatal diagnosis and pregnancy outcome prediction. Methods the serum free- 尾 -HCG, 渭 E3FP-AFP levels of 25,520 pregnant women with single pregnancy were detected by time-resolved fluorescence immunoassay (DELFIAA) in our hospital from 2011 to 2013, and prenatal diagnosis of amniocentesis was performed for screening high-risk women. Patients with high risk of NTD were diagnosed by Doppler ultrasound and their pregnancy outcome was followed up. Results among 25 520 pregnant women with prenatal screening, 1254 cases with high risk (4.91%) and 818 cases with interventional prenatal diagnosis had abnormal chromosome results in 47 cases (5.75%). The results of follow-up showed that the incidence of adverse pregnancy outcome was 1.91% / 1254% in high-risk population, which was significantly higher than that of 0.1% / 24256% in low risk group. The difference was statistically significant (P 0.01). The results of prenatal diagnosis showed that the detectable rate of 21 3 signs in the elderly group was significantly higher than that in the group under 35 years old, the difference was statistically significant (P 0.01), and the analysis of 189 cases of prenatal diagnosis due to the abnormality of the median Mo M value of the single index of prenatal screening, The chromosomal abnormality rate is 3.17 / 1899. Conclusion Serological screening during middle pregnancy can not only screen fetal chromosomes and anatomical abnormalities, but also be used to guide the adverse pregnancy outcome. It is also valuable for the prevention of birth defects in elderly pregnant women. The abnormality of Mo M value in prenatal screening has certain value for fetal chromosomal abnormality.
【作者單位】： 南京醫(yī)科大學(xué)附屬無錫婦幼保健院產(chǎn)前診斷中心;
【基金】：江蘇省婦幼保健重點資助項目(F201315) 無錫市科技局指令性項目(CSEYIN1109) 無錫市醫(yī)管中心面上項目(YGZXM1510) 南京醫(yī)科大學(xué)面上項目(2013NJMU200)
【分類號】：R714.5

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