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目的 探讨建立完善孕中期筛查胎儿Down’s综合征的方法 ,增加其检出率 ,减少有创性产前诊断的盲目性。方法 应用酶联免疫吸附法 (ELISA)测定 2 1 2 4例孕中期 (1 4～ 2 0周 )妇女血清甲胎蛋白 (AFP)及 β绒毛膜促性腺激素 (β HCG)浓度 ;应用优生胜算软件综合评价妊娠Down’s综合征胎儿的风险度 ;应用羊水细胞培养方法明确诊断。结果 孕 1 4～ 2 0周孕妇血清AFP浓度随孕周的增加而增加 ,β HCG浓度随孕周的增加而迅速降低。1 6 8例 (7.91 % )为Down’s综合征高危妊娠 ,诊断Down’s综合征 3例 ,检出率 1 0 0 % ,筛查假阳性率 7.77%。结论 孕中期应用ELISA法联合筛查Down’s综合征切实可行。应注意孕周的核对以及筛查截断值的确定 ,制定良好的筛查策略
OBJECTIVE: To establish and perfect a method to screen Down’s syndrome during the second trimester of pregnancy to increase its detection rate and reduce the blindness of invasive prenatal diagnosis. Methods Serum alpha-fetoprotein (AFP) and beta-chorionic gonadotropin (β HCG) concentrations were measured in 21,14 pregnant women (14 to 20 weeks) by enzyme-linked immunosorbent assay (ELISA) Software comprehensive evaluation of pregnancy Down’s syndrome fetus risk; application of amniotic fluid cell culture method to confirm the diagnosis. Results The concentration of serum AFP increased with gestational age from 14 to 20 weeks of pregnancy, and the concentration of β HCG decreased rapidly with the increase of gestational age. One hundred and eighty-eight cases (7.91%) were Down’s syndrome at high risk of pregnancy. The diagnosis of Down’s syndrome in 3 cases, the detection rate of 100%, screening false positive rate of 7.77%. Conclusion It is practicable to use ELISA to screen Down’s syndrome in the second trimester of pregnancy. Should pay attention to the gestational age check and screening cut-off value to determine, develop a good screening strategy