【摘要】 目的建立湘西自治州地区孕中期唐氏筛查血清学标志物:甲胎蛋白(AFP)与人绒毛膜促性腺激素(HCG)的中位数方程,探讨新的中位数值对本地筛查结果的影响。方法应用电化学发光免疫测定技术,对2 619例正常妊娠的孕中期孕妇血清进行AFP及HCG水平的测定,计算各个孕周AFP及HCG的中位数,并运用统计学软件建立本地区孕期与AFP及HCG中位数的回归方程,利用本研究数据对原产筛数据重新进行风险评估,并将结果与软件内置中位数评估结果进行对比分析。结果正常妊娠孕妇血清AFP浓度与孕周呈正相关(P<0.01),HCG水平与孕周呈负相关(P<0.01);AFP/HCG浓度与孕妇体质量呈负相关(P<0.01)。在体质量校正前,与软件内置人源血清标志物相比,湘西地区孕中期妇女血清中AFP平均高6.73%,HCG平均高31.54%,且差异具有统计学意义,软件经过校正后,筛查假阳性率大幅降低。结论建立湘西地区孕中期人群的血清标志物中位数,能提该地区产前筛查中心实验室高筛查效率,从而能更有效地筛查出该地区的唐氏综合征患儿。更多还原

【Abstract】 Objective To establish the median equation of second trimester Down′s syndrome(DS)screening maternal serum markers,alpha-fetoprotein(AFP)and human chorionic gonadotrophin(HCG),in Xiangxi area and to investigate the influence of new median values on the local screening results.Methods The electrochemiluminescence immunoassay(ECLIA)was applied to detect the serum AFP and HCG levels in 2 619second-trimester normal pregnant women,the medians of AFP and HCG in each gestational week were calculated,and the regression equation between gestational period and the medians of AFP and HCG were established by using the statistical software,then the results were compared with the evaluation results of software built-in medians.Results Serum AFP level was positively correlated with the gestational week(P<0.01),the HCG level was negatively correlated with the gestational week(P<0.01);the AFP and HCG levels were negatively correlated with the body weight of pregnant woman(P<0.01).Before correcting the body weight,compared with software built-in human source serum markers,the average levels of serum AFP and HCG in Xiangxi area increased by 6.73% and 31.54% respectively,the differences were statistically significant,after correcting the software,the screening false positive rate was remarkably decreased.Conclusion The establishment of serum maker medians for second trimester pregnant woman in Xiangxi area can increase the efficiency of the second trimester DS screening,thus effectively screens out the DS fetus in local area.更多还原