中孕期母血清甲胎蛋白和游离β-hCG筛查胎儿腹裂和脐膨出的效率

目的：评估中孕期母血清甲胎蛋白（MSAFP）和游离人绒毛膜促性腺激素β亚基（β-hCG）在产前筛查胎儿腹裂和脐膨出中的价值。方法：回顾性分析2007年10月至2016年9月在杭州市五家产前筛查中心自愿接受产前筛查的622 639名孕妇的出生缺陷监测资料及产前筛查随访结果。根据有无胎儿先天性腹壁缺损（腹裂、脐膨出）将研究对象分为病例组和健康对照组。病例组是指经超声诊断并通过终止妊娠确诊为腹裂和脐膨出胎儿的孕妇共60例，包括腹裂组30例、脐膨出组30例；健康对照组为随机抽取同时期胎儿发育正常的孕妇116名。采用时间分辨荧光免疫法检测两病例和健康对照组MSAFP、游离β-hCG水平。用受试者工作特征...

Full description

Saved in:

Bibliographic Details
Published in:	浙江大学学报（医学版） Vol. 46; no. 3; pp. 268 - 273
Main Author:	陈益明张闻卢莎梅瑾王昊王姗顾琳媛张丽丹褚雪莲
Format:	Journal Article
Language:	Chinese
Published:	杭州市妇产科医院(杭州市妇幼保健院)产前诊断(筛查)中心,浙江杭州,310008%浙江大学医学院附属妇产科医院检验科,浙江杭州,310006%杭州市余杭区妇幼保健院检验科,浙江杭州,311100 2017
Subjects:	β-亚单位产前诊断人／血液因学疝妊娠中期孕妇甲胎蛋白类／血液病例对照研究绒毛膜促性腺激素脐／病因学腹壁／畸形腹裂／病绒毛膜促性腺激素,β亚单位,人/血液腹裂/病因学 Pregnancy trimester 妊娠中期病例对照研究疝,脐/病因学产前诊断 Chorionicgonadotropin Alpha-fetoproteins/blood second Hernia beta subunit Gastroschisis/etiology Prenatal diagnosis Pregnant women umbilical/etiology 腹壁/畸形孕妇 Case-control studies Abdominal wall/abnormalities 甲胎蛋白类/血液 human/blood
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	目的：评估中孕期母血清甲胎蛋白（MSAFP）和游离人绒毛膜促性腺激素β亚基（β-hCG）在产前筛查胎儿腹裂和脐膨出中的价值。方法：回顾性分析2007年10月至2016年9月在杭州市五家产前筛查中心自愿接受产前筛查的622 639名孕妇的出生缺陷监测资料及产前筛查随访结果。根据有无胎儿先天性腹壁缺损（腹裂、脐膨出）将研究对象分为病例组和健康对照组。病例组是指经超声诊断并通过终止妊娠确诊为腹裂和脐膨出胎儿的孕妇共60例，包括腹裂组30例、脐膨出组30例；健康对照组为随机抽取同时期胎儿发育正常的孕妇116名。采用时间分辨荧光免疫法检测两病例和健康对照组MSAFP、游离β-hCG水平。用受试者工作特征（ROC）曲线对MSAFP和游离β-hCG的筛查效能进行评价。结果：腹裂组孕妇MSAFP水平为4.41（0.88~11.69）MOM，脐膨出组为2.31（0.72~23.20）MOM，均高于健康对照组的0.98（0.41~2.26）MOM，差异均有统计学意义（均P〈0.01）。腹裂组血清游离β-hCG水平为1.25（0.35~19.94）MOM，高于健康对照组的0.86（0.17~6.11）MOM，差异有统计学意义（P〈0.05）；脐膨出组游离β-hCG水平为1.03（0.21~8.95）MOM，与健康对照组比较差异无统计学意义（P〉0.05）。MSAFP筛查腹裂和脐膨出胎儿的AUC分别为0.897（95%CI：0.822~0.972）和0.852（95%CI：0.762~0.942）（均P〈0.01）。MSAFP筛查先天腹壁缺损（腹裂、脐膨出）的最佳临界值为1.655 MOM，此时的敏感度为68.30%，特异度为99.60%，约登指数为0.649。结论：中孕期MSAFP筛查先天腹壁缺损具有较高的敏感度和特异度，是筛查先天腹壁缺损的一个较好的标志物。
Bibliography:	Objective：To assess the detection of maternal serum alpha fetoprotein （MSAFP） and free beta-HCG levels of second trimester for screening of fetal gastroschisis and omphalocele. Methods：Clinical data of 622 639 pregnant women from 5 prenatal screening centers in Hangzhou during October 2007 and September 2016 were analyzed retrospectively. Thirty cases of gastroschisis and 30 cases of omphalocele diagnosed by ultrasonography and postmortem findings were enrolled in the study and 116 cases of pregnant women with normal fetal development during the same period were selected as control group. The cut-off value and area under ROC curve （AUC） of MSAFP and free β-hCG for diagnosis of fetal gastroschisis and omphalocel were analyzed. Results：MSAFP levels of women with fetal gastroschisis and omphalocele were 4.41 （0.88-11.69） MOM and 2.31 （0.72-23.20） MOM, which were significantly higher than that of control group[0.98 （0.41-2.26） MOM, all P〈0.01]. Free β-hCG level of women with fetal gastroschisis was 1.25 （0.35-19.
ISSN:	1008-9292
DOI:	10.3785/j.issn.1008-9292.2017.06.07