标题：妊娠中期孕妇血清三联生化标记物在出生缺陷筛查中的应用价值

      作者：庞春玉，吴学礼
    (海口市妇幼保健院检验科，海南 海口 570203)

      卷次： 2016年27卷20期

      【摘要】 目的 探讨妊娠中期孕妇血清三联生化标记物在出生缺陷筛查中的应用价值。方法 选择我院
2014年12月至2015年12月收治的妊娠中期(15~20+6周)孕妇5922例，对所有孕妇进行甲胎蛋白(AFP)、游离人绒毛
膜促性腺激素(Free-β-HCG)、游离雌三醇(uE3)等血清生化指标检测，利用产前筛查软件评估其出生缺陷及危险
性。结果 血清学筛查孕妇中高风险共 473例，其中 21-三体综合征高风险 416例，18-三体综合征高风险 5例，
NTD高风险52例；不同年龄区间高风险的分布比较差异无统计学意义(P>0.05)；21-三体高风险、18-三体高风险及
NTD高风险检出数集中分布于孕周16~19周，检出数分别为416例、5例、52例，三组检出数比较差异无统计学意义
(P>0.05)；筛查高风险组妊娠结局异常率3.38% (16/473)，明显高于筛查低风险组的0.99% (54/5 449)，差异具有统计
学意义(P<0.05)；年龄在 20~34岁孕妇出生缺陷异常率为 2.03% (118/5 812)，低于 35~41岁孕妇异常率的 4.55%
(5/110)，差异具有统计学意义(P<0.05)。结论 妊娠中期孕妇血清三联生化标记物作为21-三体综合征、18三体综
合征及NTD等重要出生缺陷筛查指标，能有效降低胎儿出生缺陷发生率，对提高人口素质具有积极意义。

      【关键词】 妊娠中期；血清三联指标；出生缺陷；筛查

      【中图分类号】 R714.14 【文献标识码】 A 【文章编号】 1003—6350（2016）20—3307—03


Value of serum triple biochemical marker in the screening of birth defects in mid-pregnant women.
PANG
Chun-yu, WU Xue-li. Department of Clinical Laboratory, Haikou Maternal and Child Health Care Hospital, Haikou
571500, Hainan, CHINA

【Abstract】 Objective To discuss the value of serum triple biochemical marker for screening birth defects in
mid-pregnant women. Methods A total of 5 922 women in mid-term pregnancy (15~20+6 weeks), who admitted to our
hospital from Dec. 2014 to Dec. 2015, were collected. Alpha fetal protein (AFP), free human chorionic gonadotropin
(free-β-HCG), unconjugated estriol 3 (uE3) and others serum biochemical indexes of all pregnant women were detected.
Birth defects and risks were evaluated by using the software of prenatal screening in all pregnant women. Results Af-
ter serological screening, there were 473 cases of high risks, including 416 cases of high risk of Down's syndrome, 5 cas-
es of high risk of Edward syndrome, 52 cases of high risk of neural tube defect (NTD). Distribution of high risk in differ-
ent age ranges showed no statistically significant difference (P>0.05). The detection of women with high risk of Down's
syndrome, Edward syndrome and NTD concentrated in the 16 to 19 weeks gestational age, with the detection number of
416 cases, 5 cases, 52 cases, respectively, with no significant difference between the three groups (P>0.05). The abnormal
rate of pregnancy outcome in the high-risk group was significantly higher than that in low risk group, 3.38% (16/473) vs
0.99% (54/5 449), P<0.05. The abnormal rate of birth defects of pregnant women aged 20~34 years was significantly
lower than that of pregnant women aged 35~41 years, 2.03% (118/5 812) vs 4.55% (5/110), P<0.05. Conclusion As an
important indicator of Down's syndrome, Edward syndrome and NTD, serum triple biochemical marker for screening
birth defects can effectively reduce the incidence of birth defects and effectively reduce the incidence of birth defects,
which has a positive significance to improve the quality of the population.

      【Key words】 Mid-pregnant; Serum triple biochemical marker; Birth defects; Screening
·论 著·doi:10.3969/j.issn.1003-6350.2016.20.013
基金项目：海南省卫生厅科学研究课题(编号：琼卫 2013PT-36)