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目的确立孕中期21-三体及18-三体的风险截断值,提高产筛效率。方法对185 66例15～20w+6孕妇采用时间分辨免疫荧光分析法检测血清AFP、Free-βhCG的浓度,结合母龄、孕周、体重等因素计算风险率。对高风险孕妇进行羊水穿刺,并利用系统软件统计出不同风险截断值所对应的筛查阳性率、检出率及阳性预测值。结果不同风险截断值所对应的产筛效率差异很大,21-三体风险截断值为1/270时,阳性预测值1.7%,检出率80%,产筛效率达到最高;18-三体风险截断值为1/350时,阳性预测值4%,检出率100%,产筛效率最高。结论孕中期母体血清AFP、Free-βhCG测定是一种无创性检测手段,降低出生缺陷,在徐州地区适合实行,但须确立一合适风险截断值,以使产筛效率达到最高。
Objective To establish the risk cut-off values of 21- trisomy and 18-trisomy in the second trimester so as to improve the screening efficiency. Methods The serum AFP and Free-βhCG concentrations in 185 66 women aged 15-20 w + 6 were detected by time-resolved immunofluorescence analysis. The risk factors were calculated according to the factors of age, gestational age and body weight. Amniocentesis was performed on high-risk pregnant women, and the screening positive rate, detection rate and positive predictive value corresponding to different risk cut-off values were calculated by using the system software. Results The cut-off values of different risk cutoffs differed greatly. The cutoff value of 21-trisomy was 1/270, the positive predictive value was 1.7% and the detection rate was 80% Risk cut-off value of 1/350, the positive predictive value of 4%, the detection rate of 100%, the highest screening efficiency. Conclusion The maternal serum AFP and Free-βhCG in the second trimester of pregnancy is a noninvasive detection method to reduce birth defects and is suitable for implementation in Xuzhou. However, a suitable risk cut-off value should be established to maximize the screening efficiency.