發(fā)布時(shí)間：2019-06-05 14:59

【摘要】：目的觀察孕中期血清學(xué)、超聲檢查在胎兒染色體異常篩查中的應(yīng)用效果。方法采用化學(xué)發(fā)光法測定38 165例單胎孕婦血清中甲胎蛋白、游離人絨毛膜促性腺激素和(或)游離雌三醇濃度,利用隨機(jī)配載軟件計(jì)算胎兒21-三體、18-三體和神經(jīng)管畸形風(fēng)險(xiǎn)值;采用系統(tǒng)超聲檢查孕中期的10 727例孕婦。血清學(xué)提示高風(fēng)險(xiǎn)胎兒者及系統(tǒng)超聲檢查提示胎兒結(jié)構(gòu)異常者行羊膜腔穿刺羊水細(xì)胞培養(yǎng)核型分析。結(jié)果血清學(xué)檢查異常核型檢出率為4.0%(69/1 708)。超聲檢查對各種先天結(jié)構(gòu)異常檢出率為2.2%(236/10 727),異常核型檢出率為28.8%(49/170)。超聲檢查胎兒異常核型檢出率高于血清學(xué)檢查(P0.01)。血清學(xué)或超聲檢查之一異常并接受羊膜腔穿刺者1 819例,其中異常核型者103例,陽性率為5.7%。血清學(xué)、超聲檢查均異常者59例,其中異常核型檢出率為25.4%(15/59),高于單一血清學(xué)檢查(P0.01),但與單一超聲檢查比較無統(tǒng)計(jì)學(xué)差異。結(jié)論孕中期血清學(xué)檢查胎兒染色體異常假陽性率高,超聲檢查胎兒染色體檢出率高于血清學(xué)檢查。以血清學(xué)檢查為基礎(chǔ),聯(lián)合超聲檢查,可以提高產(chǎn)前胎兒染色體異常篩查準(zhǔn)確率。
[Abstract]:Objective to observe the effect of serology and ultrasound in the screening of fetal chromosome abnormalities in the second trimester of pregnancy. Methods the concentrations of alpha-fetoprotein, free human chorionic gonadotropin and / or free estriol in serum of 38165 single pregnant women were determined by chemiluminescence method. Fetal 21-trisomy was calculated by random loading software. 18-trisomy and neural tube malformation risk value; 10727 pregnant women in the second trimester of pregnancy were examined by systematic ultrasound. Serological analysis of amniotic fluid cell culture karyotype was performed in patients with high risk fetuses and those with abnormal fetal structure. Results the detection rate of abnormal karyotype in serological examination was 4.0% (69 鈮，

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