亚洲人群孕中期唐氏综合征筛查中尿游离β-人绒毛膜促性腺激素和总雌三醇的应用

Urine free beta-hCG and total estriol for Down syndrome screening during the second trimester in an Asian population.

作者信息

Hsu J J, Hsu T Y, Hsieh T T, Soong Y K, Hsieh F J, Spencer K

机构信息

Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taiwan.

出版信息

Obstet Gynecol. 1999 Jul;94(1):107-11. doi: 10.1016/s0029-7844(99)00010-1.

DOI:10.1016/s0029-7844(99)00010-1

PMID:10389728

Abstract

OBJECTIVE

To evaluate second-trimester free beta-hCG and total estriol (E3) in the maternal urine as markers for Down syndrome screening in an Asian population.

METHODS

Free beta-hCG and total E3 were measured in the urine samples of 28 Taiwanese Down syndrome pregnancies and 268 unaffected singleton pregnancies at 14-25 weeks. Results were normalized to urine creatinine concentrations and converted to multiples of the median (MoM) levels. Gestational ages were estimated by ultrasound measurements.

RESULTS

Median values of free beta-hCG, total E3, free beta-hCG to total E3 ratio, and the free beta-hCG to total E3 MoM ratio in Down syndrome pregnancies were 4.75 MoM, 0.66 MoM, 8.99 MoM, and 9.51, respectively. At a 5% false-positive rate, the observed detection rates were 36% (ten of 28) with total E3, 71% (20 of 28) with free beta-hCG, 68% (19 of 28) with free beta-hCG/total E3, and 71% (20 of 28) with free beta-hCG/total E3 MoM. When combined with maternal age, the expected detection rates were 65% with total E3, 71% with free beta-hCG, 76% with free beta-hCG/total E3, 80% with free beta-hCG/total E3 MoM, and 89% when combining free beta-hCG, total E3, and maternal age.

CONCLUSION

Urine free beta-hCG and total E3 are useful markers for Down syndrome screening during the second trimester in Taiwanese women.

摘要

目的

评估孕中期孕妇尿中游离β-人绒毛膜促性腺激素（β-hCG）和总雌三醇（E3）作为亚洲人群唐氏综合征筛查标志物的价值。

方法

测定28例台湾地区唐氏综合征妊娠孕妇和268例孕14 - 25周单胎正常妊娠孕妇的尿样中游离β-hCG和总E3。结果以尿肌酐浓度进行标准化，并转换为中位数倍数（MoM）水平。通过超声测量估算孕周。

结果

唐氏综合征妊娠孕妇中游离β-hCG、总E3、游离β-hCG与总E3比值以及游离β-hCG与总E3 MoM比值的中位数分别为4.75 MoM、0.66 MoM、8.99 MoM和9.51。在5%的假阳性率下，总E3的观察检出率为36%（28例中的10例），游离β-hCG为71%（28例中的20例），游离β-hCG/总E3为68%（28例中的19例），游离β-hCG/总E3 MoM为71%（28例中的20例）。当与孕妇年龄相结合时，总E3的预期检出率为65%，游离β-hCG为71%，游离β-hCG/总E3为76%，游离β-hCG/总E3 MoM为80%，游离β-hCG、总E3和孕妇年龄联合时为89%。