目的 探讨妊娠中期血清学筛查发现高风险孕妇的临床意义。方法 对40 046名中孕期孕妇采用时间分辨免疫荧光法检测血清中的AFP、β-HCG浓度,通过相关评估软件计算胎儿患21-三体综合征、18-三体综合征和开放性神经管畸形(NTD)的风险值;分析年龄、孕周和体重对产前筛查结果的影响。结果 　共筛查出高风险孕妇2 298例,阳性率为5.74%,其中21-三体综合征高风险2 165例,阳性率为5.41%,18-三体综合征高风险,阳性率为0.04%,133例NTD高风险,阳性率0.33%。不同孕周对21-三体高风险的筛查风险比例不同,孕龄为15 W(15~15⁺⁶ W)的孕妇21-三体综合征高风险比例较高,差异有统计学意义(P<0.05);不同体重对三种疾病的高风险发生情况相差不大,差异没有统计学意义(P>0.05);年龄越大,21-三体综合征、开放性神经管畸形高风险比例越高,差异均有统计学意义(P<0.05)。结论 　中孕期母体血清学筛查,对早期发现高风险孕妇具有重要意义,充分利用筛查结果,尽早采取合适地干预措施,可降低胎儿发生21-三体综合征,18-三体综合征及开放性神经管畸形的风险。

Objective To explore the clinical significance of serological screening for pregnant women with high risk. Methods A total of 40046 cases of pregnant women during pregnancy were detected by time-resolved immunofluorescence in the serum AFP, concentration of beta HCG, and relevant assessment software was used to calculate the fetus with the 21-trisomy syndrome, 18-trisomy syndrome and open neural tube defects (ONTD) risk of value. Prenatal screening of pregnant women with different age, gestational age and weight was analyzed. Results A total of 2298 high-risk pregnant women were screened, with a positive rate of 5.74%. Among them, 2165 cases had high risk of 21- trisomy syndrome with a positive rate of 5.41%, high risk of 18-trisomic syndrome with 0.04% positive rate. 133 cases had high risk of NTD with 0.33% positive rate. Different gestational weeks was a factor for 21-trisomic syndrome, a high risk ratio were founded at 15 weeks (15-15⁺⁶ weeks), with a significant difference (P<0.05). There was no significant difference in the risk of the three diseases among women with different weight (P>0.05).The higher the age, the higher the risk ratio of 21-trisomic syndrome and open neural tube malformation, the difference was statistically significant (P<0.05). Conclusion Maternal serological screening during the middle pregnancy is of great significance for early detection of high risk pregnant women. Taking full advantage of the screening results and taking appropriate interventions as early as possible can reduce the risks of 21-trisomy syndrome, 18-trisomy syndrome and open neural tube malformation in the fetus.