孕中期检测血清AFP-Free-β-hCG及inhibin-A产前筛查临床价值.doc

孕中期检测血清AFP\Free-β-hCG及inhibin-A产前筛查临床价值【摘要】 目的 探讨孕中期血清标记物甲胎蛋白（AFP）、游离β-人绒毛膜促性腺激素（Free-β-hCG）和抑制素A（inhibin-A）在产前筛查的实用价值。方法 对3728例孕14～20周的孕妇分别采用化学发光法和酶联免疫方法检测血清AFP、Free-β-hCG和inhibin-A浓度，通过计算机软件计算危险系数，对高风险率孕妇进行遗传咨询，在知情同意的情况下进行羊水细胞染色体的产前检查。结果 在3728例孕妇中筛查出唐氏综合征、18-三体及神经管缺损高危孕妇163例，占筛查总数的4.37%。91例进一步确诊，共检出先天缺陷7例，检出率为7.69%。结论 孕中期血清中AFP、Free-β-hCG和inhibin-A用于产前筛查能早期发现和诊断胎儿先天缺陷，对降低其出生率是有效的，可以应用于临床大范围人群的产前筛查。 【关键词】 AFP； Free-β-hCG； inhibin-A； 产前筛查 The clinical effect of serum AFP、Free-β-hCG and inhibin-A on prenatal screening in mid-pregnancy XIA Yi，XU Jing-xuan，TANG Ya-juan， HUANG Hong-qin.The Second Hospital of Danyang，Jiangsu 212300，China 【Abstract】 Objective To investigate the clinical practical effect of serum AFP、Free-β-hCG and inhibin-A on prenatal screening in mid-pregnancy.Methods Chemoluminescence and ELISA were applied to measuring the serum levels of AFP, Free-β-hCG and inhibin-A in 3728 cases of pregnant women at about 14th-20th weeks’ gestation and the risk coefficient was calculated with professional computer software, hereditary consultation was provided for the high risk pregnant women by measuring the high risk rate with special software, amniocentesis was done with their agreement.Results In 3728 cases of pregnant women，163 cases（4.37%） were high risk for Down’s syndrome, trisomy 18 and NTD. There were 7 cases with congenital defects in 91 cases, total positive rate was 7.69%.Conclusion It is operative to decrease birth rate of the fetus with congenital defects by measuring serum AFP、Free-β-hCG and inhibin-A in mid-pregnancy, which can early discover diagnose the fetus with congenital defects. And， the strategy may be used on clinical prenatal screening in extensiveness crowd. 【Key words】 AFP； Free-β-hCG； Inhibin-A； Antenatal screening 唐氏综合征（Down’S syndrome，DS）是最常见的一种严重先天性智力发育不全性疾病，临床上以明显的智力和生长发育障碍、特殊面容和多发畸形为特征，发病率约为1/650～1/1000［1］。神经管缺陷是一种严重的先天畸形，发病率约为1/1000，目前尚无有效的治疗方法，给患者家庭和社会带来了极大的经济负担和心理负担，因此，早期诊断先天缺陷并降低其发病率，避免此类患儿的出生引起了社会的广泛关注。通过对孕中期血清一些物质，如AFP，hCG，i