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囊性纤维化的产前筛查:回顾5年经验。

Prenatal screening for cystic fibrosis: 5 years' experience reviewed.

作者信息

Brock D J

机构信息

Human Genetics Unit, University of Edinburgh, Western General Hospital, UK.

出版信息

Lancet. 1996 Jan 20;347(8995):148-50. doi: 10.1016/s0140-6736(96)90340-2.

Abstract

BACKGROUND

Although several programmes of prenatal screening for cystic fibrosis have been completed and reported, there are still uncertainties about rates of take up and also about the action of parents identified as having a one-in-four risk of an affected child. I report 5 years' experience with the two-step and couple models of prenatal screening of cystic fibrosis.

METHODS

Screening has been available at two antenatal clinics in Edinburgh, UK, since January, 1992, first on a research basis and then routinely. 25,000 couples have been screened.

FINDINGS

Take-up rates for the two-step and couple models of delivery are very similar at about 70%. Take-up rates did not change when screening moved from a research to a routine service. Of 22 high-risk couples identified entirely through screening, 20 (91%) opted for prenatal diagnosis. Four couples returned for second and two for third monitored pregnancies. In all eight cases where affected fetuses were identified, pregnancy was terminated.

INTERPRETATION

These data remove one of the few remaining obstacles to a general implementation of prenatal screening for cystic fibrosis.

摘要

背景

尽管已经完成并报告了多项囊性纤维化产前筛查项目,但对于筛查的接受率以及被确定为生育患病孩子风险为四分之一的父母的行为仍存在不确定性。我报告了5年中使用两步法和夫妇模式进行囊性纤维化产前筛查的经验。

方法

自1992年1月起,英国爱丁堡的两家产前诊所提供筛查服务,起初是基于研究目的,之后转为常规服务。共有25000对夫妇接受了筛查。

结果

两步法和夫妇模式的筛查接受率非常相似,约为70%。当筛查从研究性服务转变为常规服务时,接受率并未改变。在完全通过筛查确定的22对高危夫妇中,20对(91%)选择了产前诊断。4对夫妇再次接受监测妊娠,2对夫妇第三次接受监测妊娠。在所有8例确定为患病胎儿的病例中,均终止了妊娠。

解读

这些数据消除了全面实施囊性纤维化产前筛查的少数剩余障碍之一。

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