Lowry D L, Campbell S A, Krivchenia E L, Dvorin E, Duquette D, Evans M I
Department of Obstetrics and Gynecology, Hutzel Hospital/Wayne State University School of Medicine, Detroit, Mich 48201, USA.
Fetal Diagn Ther. 1995 Sep-Oct;10(5):286-9. doi: 10.1159/000264245.
The development of multiple-marker biochemical screening has increased the percentage of aneuploidies detected for all age groups and has also increased the abnormality/amniocentesis ratio from about 1 in 85 for maternal serum alpha-fetoprotein alone (single screening) to about 1 in 50 for either maternal serum alpha-fetoprotein plus human chorionic gonadotropin (double screening) or maternal serum alpha-fetoprotein combined with human chorionic gonadotropin and unconjugated estriol (triple screening). We evaluated the decisions to have or decline amniocentesis of 985 patients 'at risk' by either single, double, or triple screening, as multiple markers were phased in over a 3-year period. The patient acceptance of the procedure did not change (approximately 80%) either by actual risk or type of biochemical screening. The labeling of 'at risk' status is more important than actual numerical risks, and the patient perception of risk status must be considered in counseling.
多种标志物生化筛查的发展提高了所有年龄组非整倍体的检出率，同时也将异常/羊膜穿刺术的比例从单独使用母血清甲胎蛋白（单项筛查）时的约1/85提高到母血清甲胎蛋白加人绒毛膜促性腺激素（双项筛查）或母血清甲胎蛋白与人绒毛膜促性腺激素及未结合雌三醇联合使用（三项筛查）时的约1/50。在3年的时间里逐步引入多种标志物后，我们评估了985例通过单项、双项或三项筛查“有风险”患者进行或拒绝羊膜穿刺术的决定。无论实际风险或生化筛查类型如何，患者对该操作的接受率均未改变（约80%）。“有风险”状态的标记比实际数字风险更重要，在咨询过程中必须考虑患者对风险状态的认知。
