摘要
目的本研究通过分析抚州市孕中期妇女唐氏综合征(DS)血清学临床筛查结果,为当地优生优育提供参考。方法选择2014-03-01-2018-08-31到抚州市第一人民医院参加DS筛查的孕中期孕妇为研究对象,分析其血清甲胎蛋白(AFP)、β-人绒毛膜促性腺激素(β-HCG)、游离雌三醇(uE3)和抑制素A(Inh-A)检测结果,评估胎儿DS、18三体综合征(ES)和开放性神经管缺陷(ONTD)的风险性,并分析DS影响因素。结果5590例孕妇中共筛查出高风险孕妇346例(6.19%),其中DS、ES和ONTD阳性率分别为5.04%、1.09%和0.38%。DS(χ2MH=188.901,P<0.001)和ES(χ2MH=20.243,P<0.001)筛查阳性率随着年龄增加总体呈上升趋势;不同年份ES筛查阳性率总体呈下降趋势,χ2MH=7.529,P=0.006。Logistic回归分析显示,年龄(OR=16.70,95%CI为12.31~22.65,P<0.001)、β-HCG(OR=12.80,95%CI为8.59~19.09,P<0.001)和Inh-A(OR=11.51,95%CI为7.07~18.75,P<0.001)是DS的危险因素;AFP(OR=0.05,95%CI为0.04~0.08,P<0.001)和uE3(OR=0.10,95%CI为0.06~0.17,P<0.001)是DS的保护因素。结论孕中期血清学四联筛查是发现DS、ES和ONTD高危人群的重要指标,提倡适龄生育,普及产前筛查有利于降低先天缺陷儿的出生率。
Objective This study aimed to analyze the clinical screening results of Down syndrome(DS)of women in the second trimester of pregnancy in Fuzhou City,and to provide references for local prenatal and postnatal care.Methods The second trimester pregnant women who participated in DS screening at Fuzhou First People’s Hospital from March 1,2014 to August 31,2018 were selected as the research subjects,and their serum alpha-fetoprotein(AFP),β-human chorionic gonadotropin(β-HCG),free estriol(uE3)and inhibin A(Inh-A)were analyzed.The risk of fetal DS,Edwards syndrome(ES)and open neural tube defect(ONTD)were evaluated,and the influencing factors of DS were analyzed.Results A total of346 high-risk pregnant women(6.19%)were screened out of 5590 pregnant women.The positive rates of DS,ES and ONTD were 5.04%,1.09%and 0.38%.The positive rates of DS(χ2 MH=188.901,P<0.001)and ES(χ2 MH=20.243,P<0.001)showed an overall upward trend with age.The positive rates of ES screening in different years showed an overall downward trend,χ2 MH=7.529,P=0.006.Logistic regression analysis showed that age(OR=16.70,95%CI:12.31-22.65,P<0.001),β-HCG(OR=12.80,95%CI:8.59-19.09,P<0.001)and Inh-A(OR=11.51,95%CI:7.07-18.75,P<0.001)were risk factors for DS.AFP(OR=0.05,95%CI:0.04-0.08,P<0.001)and uE3(OR=0.10,95%CI:0.06-0.17,P<0.001)were the protective factors for DS.Conclusions The quadruple screening of serological screening in the second trimester is an important indicator for finding high-risk groups of DS,ES and ONTD.Promoting childbirth at an appropriate age and popularizing prenatal screening will help reduce the birth rate of children with birth defects.
作者
上官致洋
唐龙泉
傅梅
朱小康
SHANGGUAN Zhi-yang;TANG Long-quan;FU Mei;ZHU Xiao-kang(Department of Public Health,Fuzhou Medical College of Nanchang University,Fuzhou344000,China;Department of Laboratory Medicine,Fuzhou First People's Hospital,Fuzhou344000,China)
出处
《社区医学杂志》
CAS
2021年第4期212-214,218,共4页
Journal Of Community Medicine
基金
江西省教育厅科学技术研究(180113)
