云南省6州/市先天性甲状腺功能减低症筛查中TSH切值的确立
The Determination of Cut-off Value of TSH during Screening of Congenital Hypothyroidism in 6 Prefecture/City of Yunnan Province
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摘要: 目的 探讨制定合理的新生儿遗传代谢病筛查中心实验室先天性甲状腺功能减低症 (congenital hypothyroidism, CH) 的筛查切值, 减少漏诊率, 同时降低假阳性率.方法 新生儿于出生72 h后采集足跟血, 滴于专用S&S903号滤纸上, 在规定的时间内递送到新生儿遗传代谢病筛查中心, 采用时间分辨荧光免疫分析方法 (Tr-FIA) , 检测滤纸干血片促甲状腺激素 (TSH) 浓度.结果 2012至2016年度共检测529 918份新生儿足跟血标本, TSH水平呈正偏态分布, 检出正常新生儿数为529645, 确诊CH患儿203例, 高TSH血症患儿70例, 总检出率为1:1941, CH发病率为1:2 610.根据筛查结果, 确定实验室时间分辨荧光免疫法筛查CH的TSH参考切值为9.0 m IU/L, 其灵敏度达100%, 特异度98.38%, 漏诊率0%.结论 新生儿遗传代谢病筛查中心实验室CH的筛查切值定为9.0 m IU/L, 较适合云南省6州/市人群, 也为实验室今后的新生儿CH筛查提供了依据.
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关键词:
- 新生儿疾病筛查 /
- 先天性甲状腺功能减低症 /
- 促甲状腺激素 /
- 切值
Abstract: Objective To explore the positive cut-off value in neonatal screening for congenital hypothyroidism (CH) in the center of Neonatal Screening, so as to improve screening efficiency and reduce false positive rate. Methods Heel blood samples were taken from the newborns born after72 hours, dropped in special S&S903 filter paper and delivered to the neonatal screening center within the prescribed period of time.DELFIA was applied to detect the concentration of thyroid-stimulating hormone (TSH) .Result Totally 529918 blood sample were screened from the 2012 to the 2016.Among them 529645 newborns were normal, 203 neonates were diagnosed with CH, 70 with high TSH hyperlipidemia, the total detection rate was 1:1941, and the incidence of CH was 1:2 610. According to the results, the cut-off value of the screening of CH in the center of Neonatal Screening was 9.0 m IU/L, the sensitivity was 100%and specifility was 98.38%, misdiagnosis rate was 0%.Conclusion The cut-off value of CH was 9.0 m IU/L in the center of Neonatal Screening, which is suitable for the people in 6 Prefecture/City of Yunnan Province, and also provides the basis for neonatal scree of CH in the future. -
[1]石剑霞.象山地区新生儿疾病筛查10年回顾分析[J].中国优生与遗传杂志, 2012, 20 (3) :79-80. [2]顾学范, 叶军.新生儿疾病筛查[M].上海:上海科学技术文献出版社, 2003. [3]孙巧玲, 崔琼, 陈建华, 等.593例先天性甲状腺功能减低症结果分析[J].中国农村卫生事业管理, 2012, 32 (5) :514-515. [4]周婧瑶, 欧明才, 罗晓菊, 等.四川省新生儿CH筛查切值的探讨[J].中国妇幼健康研究, 2013, 24 (5) :638-640. [5]蒋翔, 江剑辉, 李蓓, 等.广州市新生儿先天性促甲状腺素筛查切值的建立和探讨[J].中国儿童保健杂志, 2013, 21 (4) :385-387. [6]邓耀明, 宋兵文, 杨白兰, 等.株洲地区新生儿先天性甲状腺功能减低症筛查TSH切值的建立[J].中国优生与遗传杂, 2012, 20 (7) :83-85. [7]陈实庆, 陈军, 邓虹, 等.安庆市新生儿先天性甲状腺功能减退症TSH筛查切值探讨[J].中国儿童保健杂志, 2016, 24 (2) :217-222. [8]周晓莹, 陈用庚, 叶青, 等.新生儿先天性甲状腺功能低下症筛查切值探讨[J].海南医学, 2014, 25 (7) :989-991. [9]孙健, 姜东, 陈亚平, 等.苏州市新生儿先天性促甲状腺素筛查切值的研究[J].南京医科大学学报, 2011, 31 (4) :576-578. [10]罗莹, 梁涛, 何明, 等.2012~2015年梧州市先天性甲状腺功能减低症筛查、治疗及随访情况[J].广西医学, 2017, 39 (6) :863-866. [11]中华医学会儿科学分会内分泌遗传代谢学组, 中华预防医学会儿童保健分会新生儿疾病筛查学组.先天性甲状腺功能减低症诊疗共识[J].中华儿科杂志, 2011, 49 (6) :421-424. [12]王琼, 黎曼侬, 党峰博, 等.新生儿先天性甲状腺功能减低症筛查中促甲状腺激素切值的探讨[J].中国妇幼保健, 2016, 31 (3) :507-508. [13]方可欣, 吴鼎文, 胡真真, 等.滤纸干血片打孔部位对新生儿筛查实验检测结果的影响[J].现代诊断与治疗, 2017, 28 (6) :1068-1069. -
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