摘要
目的探究孕妇血清抑制素A联合胎盘生长因子在孕早期唐氏综合征(DS)产前筛查中的应用。方法选取2017年6月至2019月6月于本院进行孕早期DS筛查的11 W^13 W+6孕周190例孕妇,根据诊断结果分为实验组(胎儿患DS孕妇,n=25)和正常组(正常孕妇,n=165)。检测并对比两组血清抑制素A(Inhibin-A,Ih-A)、胎盘生长因子(PLGF)、妊娠相关蛋白A(PAPP-A)和游离人绒毛膜促性腺激素β亚单位(freeβ-hCG)水平。结果孕早期实验组血清Ih-A、freeβ-hCG水平显著高于正常组,PLGF、PAPP-A水平均显著低于正常组,差异有统计学意义(P<0.05);根据ROC曲线分析结果显示,血清二联筛查(PAPP-A+freeβ-hCG)诊断孕早期胎儿DS的敏感度为72.22%、特异度为93%、准确性为83.16%;四联筛查(Ih-A+PLGF+PAPP-A+freeβ-hCG)诊断孕早期胎儿DS的敏感度为93.33%、特异度为95%、准确性为94.21%;四联筛查的敏感度及特异性均明显高于二联筛查,差异有统计学意义(P<0.05)。结论Ih-A、PLGF均是孕早期筛查DS胎儿的有效血清指标,Ih-A+PLGF+PAPP-A+freeβ-hCG联合检测对DS的筛查效果更佳,有助于提高孕早期胎儿DS的筛查准确性。
Objective To explore the application of serum inhibin A combined with placental growth factor in prenatal screening of Down s syndrome(DS)in early pregnancy.Methods 90 pregnant women of 11 W-13 W+6 gestational weeks who underwent DS screening in our hospital from June 2017 to June2019 were divided into the experimental group(pregnant women with DS,n=25)and the normal group(normal pregnant women,n=165)according to the diagnosis results.Serum inhibin A(Inhibin-A,Ih-A),placental growth factor(PLGF),pregnancy-related protein A(PAPP-A)and free human chorionic gonadotropin beta subunit(free beta-hCG)levels were measured and compared between the two groups.Results The serum levels of Ih-A and free beta-hCG in the early pregnancy group were significantly higher than those in the normal group,and the levels of PLGF and PAPP-A were significantly lower than those in the normal group(P<0.05).According to the analysis of ROC curve,the sensitivity of PAPP-A+free beta-hCG in diagnosing fetal DS in the early pregnancy was 72.22%,especially in the early pregnancy group.The sensitivity,specificity and accuracy of quadruple screening(Ih-A+PLGF+PAPP-A+free beta-hCG)were 93.33%,95%and94.21%,respectively.The sensitivity and specificity of quadruple screening were significantly higher than those in double screening(P<0.05).Conclusion Both Ih-A and PlGF are effective serum indexes for screening DS fetus in early pregnancy.The combination of Ih-A+PlGF+PAPP-A+freeβ-hCG has better screening effect on DS and helps to improve the screening accuracy of DS fetus in early pregnancy.
作者
黄雪珍
陈倩岚
蔡锦梅
孙丽丽
HUANG Xuezhen;CHEN Qianlan;CAI Jinmei;SUN Lili(Department of Inspection,Xiaolan Affiliated Hospital of Southern Medical,Zhongshan,Guangdong,China,528415)
出处
《分子诊断与治疗杂志》
2020年第8期1044-1046,1055,共4页
Journal of Molecular Diagnostics and Therapy
基金
中山市科技局科研项目(2017B1062)。
