临沂地区孕中期产前筛查血清标志物中位数方程的建立及其与体重相关性研究
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摘要
目的建立适合临沂地区孕中期孕妇血清标志物中位数方程,并探讨新建中位数与体重的相关性。方法利用Prisca 4产筛风险计算软件对临沂地区92373名孕105-146d孕妇进行风险评估,应用统计学软件对孕妇血清的甲胎蛋白(alpha-fetoprotein,AFP)、人绒毛膜促性腺激素(human chorionic gonadotrophin,HCG)、游离雌三醇(unconjugated oestriol,uE3)进行统计,并建立适合本地不同孕周孕妇AFP、HCG和uE3中位数的回归方程。经体重校正得到新的中位数,并将产筛数据进行重新评估风险,并将结果与软件内置中位数评估的数据进行比较和统计分析。结果与Prisca4软件内置模型的血清标记物相比,临沂地区孕中期孕妇的甲胎蛋白(AFP)平均高出24%、人绒毛膜促性腺激素(HCG)高出17%,而游离雌三醇(uE3)与软件内置参数基本一致;经孕龄和体重校正后,临沂地区人群模型与Prisca4软件内置模型计算的血清标记物中位值倍数(multiple of the median,MOM)的中位值有明显的差异,且差异有统计学意义。结论建立临沂地区孕中期人群的血清标志物中位数方程非常必要,经体重校正后得到的新中位数能更有效的保证风险概率的准确性,提高产前筛查及产前诊断的效率。
Objective To establish a suitable median equation of the maternal serum markers in the second trimester and explore the relevance between the new median and body weight in Linyi region.Methods Prisca 4 prenatal screen risk calculation software was used to assess the risk of the 92,373 women with pregnant 105-146 days.We analyses alpha-fetoprotein(AFP),human chorionic gonadotropin(HCG),unconjugated estriol(uE3)statistically with the application of statistical software for maternal serum and established the median regression equation.of AFP,HCG and uE3 suited local pregnant women with different gestational weeks.We re-evaluated the risk of the prenatal screen data when we got the new median after weight-adjusted,the results were compared and statistically analyses with the data assessed by the median built-in software.Results In Linyi,AFP of the secondtrimester were 24% higher than the serum markers built-in software Prisca 4 on average,HCG adding to17%,while the uE3 as the same as the parameters built-in software.The median value of the multiple of the median(MOM)of serum markers were significantly different between the crowd model in Linyi and the model calculated by Prisca4 software after revised gestational age and weight,and the difference was statistically significant.ConclusionIt is necessary to establish median equation of serum markers belonged to Linyi second trimester crowd,a new median obtained after weight-adjusted can more effectively guarantee the accuracy of risk probability,and improve the efficiency of prenatal screening and prenatal diagnosis.
Objective To establish a suitable median equation of the maternal serum markers in the second trimester and explore the relevance between the new median and body weight in Linyi region.Methods Prisca 4 prenatal screen risk calculation software was used to assess the risk of the 92,373 women with pregnant 105-146 days.We analyses alpha-fetoprotein(AFP),human chorionic gonadotropin(HCG),unconjugated estriol(uE3)statistically with the application of statistical software for maternal serum and established the median regression equation.of AFP,HCG and uE3 suited local pregnant women with different gestational weeks.We re-evaluated the risk of the prenatal screen data when we got the new median after weight-adjusted,the results were compared and statistically analyses with the data assessed by the median built-in software.Results In Linyi,AFP of the secondtrimester were 24% higher than the serum markers built-in software Prisca 4 on average,HCG adding to17%,while the uE3 as the same as the parameters built-in software.The median value of the multiple of the median(MOM)of serum markers were significantly different between the crowd model in Linyi and the model calculated by Prisca4 software after revised gestational age and weight,and the difference was statistically significant.ConclusionIt is necessary to establish median equation of serum markers belonged to Linyi second trimester crowd,a new median obtained after weight-adjusted can more effectively guarantee the accuracy of risk probability,and improve the efficiency of prenatal screening and prenatal diagnosis.
引文
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[6]蓝信强,王淑惠,邓玉芝.威海地区妊娠中期孕妇血清标志物中位数的建立[J].中华医学遗传学杂志,2012,29:693-696.
[7]俞冬熠,王芳,刘奇,等.青岛地区孕中期产前筛查指标中位数的建立及其对筛查效率的影响[J].中华医学遗传学杂志,2012,29:587-591.
[8]韦家伟,蔡稔,唐宁,等.唐氏综合征筛查方法比较及孕妇血清指标中位数探讨[J].检验医学与临床,2010,7:1034-1039.
[9]许碧云,胡娅莉,张春延,等.江苏地区孕中期唐氏综合征筛查母血清标志物中位倍数标化方法的探讨[J].中华医学遗传学杂志,2008,25:32-35.
[10]Brien J E,Dvorln E.Drugan A,et a1.Race ethnicity—specificvariatlon in multiple—marker biochemicaI screening:alphafetoprotein,hCG,and estriol[J].Int J Gynaecol,1997,89:355-358.
[11]Knight GJ,Palomaki GE.Epidemiologic monitoring of prenatal screening for neural tube defects and Down syndrome[J].Clin Lab Med,2003,23(2):531.
[2]Beaman JM,Goldie DJ.Second trimester screening for Down’S syndrome:7years experience[J].J Med Screen,2001,8:128-131.
[3]李辉,王德智.唐氏综合征产前筛查的进展[J].中国实用妇科与产科杂志,2008,24:8-10.
[4]Muller F,Dreux S,Oury JF,et a1.Down syndrome maternal serum marker screening after 18 weeks’gestation[J].Prenat Diagn,2002,22:1001-1004.
[5]唐少华,毛义建,潘胜勇,等.正常孕妇中期产前筛查指标中位数数据库的建立.中华检验医学杂志,2009,32:309-314.
[6]蓝信强,王淑惠,邓玉芝.威海地区妊娠中期孕妇血清标志物中位数的建立[J].中华医学遗传学杂志,2012,29:693-696.
[7]俞冬熠,王芳,刘奇,等.青岛地区孕中期产前筛查指标中位数的建立及其对筛查效率的影响[J].中华医学遗传学杂志,2012,29:587-591.
[8]韦家伟,蔡稔,唐宁,等.唐氏综合征筛查方法比较及孕妇血清指标中位数探讨[J].检验医学与临床,2010,7:1034-1039.
[9]许碧云,胡娅莉,张春延,等.江苏地区孕中期唐氏综合征筛查母血清标志物中位倍数标化方法的探讨[J].中华医学遗传学杂志,2008,25:32-35.
[10]Brien J E,Dvorln E.Drugan A,et a1.Race ethnicity—specificvariatlon in multiple—marker biochemicaI screening:alphafetoprotein,hCG,and estriol[J].Int J Gynaecol,1997,89:355-358.
[11]Knight GJ,Palomaki GE.Epidemiologic monitoring of prenatal screening for neural tube defects and Down syndrome[J].Clin Lab Med,2003,23(2):531.