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目的分析孕中期母体血清hAFP、freeβ-HCG、uE3的变化及产前筛查的应用价值。方法采用时间分辨荧光免疫技术检测孕中期母体血清标志物hAFP、freeβ-HCG、uE3的含量,结合孕妇年龄、孕周、体重等因素用Risk2T软件进行风险评估,根据评估结果,将同孕周高、低风险孕妇的hAFP、freeβ-HCG、uE3含量进行统计分析;同时,建议高风险孕妇进一步确诊。结果低风险母体血清hAFP、uE3含量与孕周呈正相关,freeβ-HCG含量与孕周呈负相关;21-三体高风险母体血清hAFP、uE3含量明显低于低风险母体血清该指标含量,差异有统计学意义(P<0.01);而freeβ-HCG含量明显高于低风险时该指标含量,差异有统计学意义(P<0.01);18-三体高风险的母体血清hAFP、freeβ-HCG含量均低于低风险时该指标含量,差异有统计学意义(P<0.01)。9969例孕妇中,筛查出21-三体、18-三体及NTD高风险共288例,筛查阳性率2.9%;107例进行了产前诊断,共确诊19例,确诊率为17.8%,分别为:21-三体6例、18-三体2例,NTD 3例,其他异常儿8例。结论孕中期母体血清3项指标呈规律性变化,检测该指标可发现高风险孕妇;产前筛查结合产前诊断能有效降低出生缺陷率。
Objective To analyze the change of maternal serum hAFP, freeβ-HCG and uE3 in the second trimester of pregnancy and the value of prenatal screening. Methods The levels of hAFP, freeβ-HCG and uE3 in the second trimester of pregnant women were detected by time-resolved fluorescence immunoassay. Risk2T software was used to assess the risk of pregnant women with age, gestational age and body weight. According to the assessment results, , HAFP, freeβ-HCG and uE3 levels in low-risk pregnant women were statistically analyzed. At the same time, it was suggested that further diagnosis of high-risk pregnant women. Results The levels of hAFP and uE3 in low risk maternal serum were positively correlated with gestational age and the content of freeβ-HCG was negatively correlated with gestational age. The hAFP and uE3 levels in 21- trisomy high risk maternal serum were significantly lower than those in low risk maternal serum (P <0.01). However, the content of freeβ-HCG was significantly higher than that of low-risk group (P <0.01). The levels of hAFP and freeβ-HCG in maternal serum of 18- The indicator content was lower than the low risk, the difference was statistically significant (P <0.01). In 9969 pregnant women, 288 cases with high risk of 21-trisomy, 18-trisomy and NTD were screened, the screening positive rate was 2.9%; 107 cases were diagnosed prenatally, 19 cases were confirmed, the diagnosis rate was 17.8% , Respectively: 6 cases of 21-trisomy, 2 cases of 18-trisomy, 3 cases of NTD and 8 cases of other abnormalities. Conclusion Three variables of maternal serum in the second trimester of pregnancy are changed regularly. Detection of this index can detect high risk pregnant women. Prenatal screening combined with prenatal diagnosis can effectively reduce the birth defect rate.