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目的对比分析孕早中期整合产前筛查与孕中期三联产前筛查对检出胎儿染色体异常和神经管畸形的筛查效率,探讨整合产前筛查的临床价值,寻求更好的产前筛查模式。方法 5993名孕早中期整合产前筛查孕妇孕早期(11w~13+5w)检测血清标志物PAPP-A、Freeβ-HCG,于孕中期(15w~20+6w)测定血清标志物AFP、Freeβ-HCG、u E3,同期12 665名孕妇行孕中期三联筛查(检测母血清标志物AFP、Freeβ-HCG、u E3),对筛查高风险孕妇进行后续产前诊断,并对妊娠结局进行随访,将两组筛查效果进行对比分析。结果整合筛查组高风险率2.97%,假阳性率2.80%,阳性预测值5.62%,明显低于孕中期筛查组,两组差异有显著统计学意义。结论整合产前筛查组具有更低的假阳性率,避免了很多不必要的侵入性的产前诊断,是更有效的产前筛查模式。
OBJECTIVE: To compare the screening efficiency of prenatal screening and prenatal triad trimester screening screening for fetal chromosomal abnormalities and neural tube defects in the first trimester of pregnancy, and to explore the clinical value of integrating prenatal screening in order to find better prenatal screening Screening mode. Methods 5993 pregnant women with early pregnancy and early pregnancy were tested for PAPP-A and Freeβ-HCG during the first trimester of pregnancy (11w ~ 13 + 5w). Serum markers AFP, Freeβ -HCG, uE3, 12,665 pregnant women during the second trimester screening (detection of serum markers of AFP, Freeβ-HCG, uE3) in the second trimester of pregnancy, followed by prenatal diagnosis of high risk pregnant women screening, and pregnancy outcomes Follow-up, the two screening results were compared. Results The integrated screening group had a high risk of 2.97%, a false positive rate of 2.80% and a positive predictive value of 5.62%, which was significantly lower than that of the second trimester screening group. The differences between the two groups were statistically significant. Conclusion The integrated prenatal screening group has a lower false positive rate, avoids many unnecessary invasive prenatal diagnosis and is a more effective mode of prenatal screening.