Drugan A, Syner F N, Belsky R, Koppitch F C, Evans M I
Department of Obstetrics and Gynecology, Hutzel Hospital, Wayne State University, Detroit, MI 48201.
Am J Obstet Gynecol. 1988 Aug;159(2):469-74. doi: 10.1016/s0002-9378(88)80111-x.
The implications of an "inconclusive" acetylcholinesterase test (a faint but true band) in amniotic fluid were studied over a 2 1/2-year period in our laboratory. One thousand one hundred fifty-four amniotic fluid samples were tested for acetylcholinesterase and alpha-fetoprotein; the rate of an inconclusive acetylcholinesterase result was 3.3% (38 of 1154). Fourteen such results were found in patients with a high amniotic fluid alpha-fetoprotein level (23.3%), and 24 results were associated with normal amniotic fluid alpha-fetoprotein levels (2.19%). The rates of congenital fetal malformation associated with an inconclusive acetylcholinesterase result in the two groups were 57.14% and 37.5%, respectively. In amniotic fluid samples obtained before 15 weeks' gestation, there was a higher rate of inconclusive acetylcholinesterase tests (9.29%), but a lower percentage of malformed fetuses were found compared with later in pregnancy (2.46% and 56%, respectively). Thus we suggest the terminology "equivocal" for early specimens and "suspicious" for later specimens. If obtained in early second trimester and the ultrasound scan is normal, such findings implicate the need for a careful search for fetal malformations. A positive pregnancy outcome may be expected in most cases.
在我们实验室，对羊水乙酰胆碱酯酶检测结果“不确定”（一条 faint 但真实的条带）的意义进行了为期两年半的研究。1154 份羊水样本检测了乙酰胆碱酯酶和甲胎蛋白；乙酰胆碱酯酶检测结果不确定的比例为 3.3%（1154 份样本中有 38 份）。在羊水甲胎蛋白水平高的患者中发现 14 份这样的结果（23.3%），24 份结果与羊水甲胎蛋白水平正常相关（2.19%）。两组中与乙酰胆碱酯酶检测结果不确定相关的先天性胎儿畸形发生率分别为 57.14%和 37.5%。在妊娠 15 周前获得的羊水样本中，乙酰胆碱酯酶检测结果不确定的比例较高（9.29%），但与妊娠后期相比，发现的畸形胎儿比例较低（分别为 2.46%和 56%）。因此，我们建议将早期样本的术语称为“可疑”，后期样本称为“疑似”。如果在孕中期早期获得且超声扫描正常，这些发现意味着需要仔细寻找胎儿畸形。大多数情况下可预期有良好的妊娠结局。
