【摘要】 目的评价抑制素A在孕中期唐氏综合征产前筛查的应用价值。方法选取已知妊娠结局的27例唐氏综合征和800例正常孕妇的冻存标本,采用免疫化学发光方法检测孕妇血清中甲胎蛋白(AFP)、人绒毛膜促性腺激素(hCG)、游离雌三醇(uE3)和抑制素A(Inhibin-A)的水平,结合孕妇信息分析孕中期血清学三联筛查(AFP、hCG、uE3)和四联筛查(AFP、hCG、uE3、Inhibin-A)胎儿发生唐氏综合征的风险概率。结果唐氏综合征组孕妇血清抑制素A的MOM中值显著高于正常孕妇组,差异有统计学意义(P<0.05);以1/270作为阳性切割(cut-off)值时,四联筛查唐氏综合征的检出率为81%,较三联筛查的检出率提高7%;假阳性率为4.6%,较三联筛查的假阳性率降低0.8%。ROC曲线显示,四联筛查曲线下面积(0.972)大于三联筛查曲线下面积(0.968)。结论血清抑制素A是一种有效的孕中期产前筛查血清标志物,孕中期血清学唐氏综合征四联筛查效率优于三联筛查。更多还原

【Abstract】 Objective To assess the value of inhibin- A in the pregnantal screening of Down’s syndrome at the mid- pregnancy trimester. Methods Frozen blood samples were collected from women with Down’s syndrome( n = 27) and normal( n =800) fetuses. The concentrations of alpha fetoprotein( AFP),human chorionic gonadotrophin( hCG),unconjugated oestriol( uE3) and inhibin A( Inhibin- A) in maternal serum were measured by automatic enzyme linked immunosorbent chemiluminescence assay. The risk of Down’s syndrome was evaluated by using the triple test( AFP,hCG,uE3) and quadruple test( AFP,hCG,uE3,Inhibin- A) combined with pregnant women information. Results The MOM median of inhibin- A in pregnant women with Down’s syndrome fetuses was significantly higher than those without,and the differences were statistically significant( P < 0. 05); the positive cut- off was set as 1 /270,and the detection rate was 81% by using the quadruple screening,which increased by 7% than the triple screening; the false positive rate was 4. 6%,which decreased by 0. 8% than the triple screening; the ROC curve showed that the area under the curve of screening( 0. 972) of quadruple screening was more than that of the triple screening( 0. 968). Conclusion Inhibin- A is an effective marker for the mid pregnancy trimester screening,the quadruple screening has higher efficiency than triple screening on Down’s syndrome.更多还原