四川省新生儿CH筛查切值的探讨  

Exploration of cut-off value of TSH during screening of congenital hypothyroidism in the newborns in Sichuan

作　　者：周婧瑶[1] 欧明才[1] 罗晓菊[1] 张钰[1] 胡琦[1] 陈雪莲[1] 杨丽娟[1] 王蕊[1] 李婷[1] 

机构地区：[1]四川省妇幼保健院,四川成都610045

出　　处：《中国妇幼健康研究》2013年第5期638-640,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨四川省新生儿疾病筛查中心实验室先天性甲状腺功能减低症(CH)筛查切值,减少漏诊率,降低假阳性率。方法对四川省新生儿疾病筛查中心片区市县2011至2012年活产婴儿出生72小时并充分哺乳6次后取其足跟血,采用时间分辨荧光免疫法检测血中促甲状腺激素(TSH)浓度。结果 2011至2012年度共测定525 941例标本,其TSH浓度呈偏态分布,其中正常新生儿人数为525 554,确诊CH患儿230例,高TSH血症患儿157例。当筛查切值定为8.0mIU/L和定为8.9mIU/L时,灵敏度x^2=10.188,P<0.05;特异度x^2=458.460,P<0.05,制定出四川省新生儿疾病筛查中心实验室时间分辨荧光免疫法筛查CH参考切值为8.0mIU/L。结论四川省新生儿疾病筛查中心制定的CH筛查切值是适宜的、有依据的,为更大规模开展的新生儿CH筛查提供了决策依据。Objective To explore the positive cut-off value in neonatal screening for congenital hypothyroidism （CH） in the Centre of Neonatal Screening of Sichuan , so as to improve screening efficiency and reduce false positive rate .Methods DELFIA was applied to detect the concentration of thyroid-stimulating hormone （ TSH） in heel blood samples which were collected from the newborns 72 hours after birth and having drunk enough milk for at least 6 times.These neonates were born in 2011-2012 in counties and cities managed by the Centre of Neonatal Screening of Sichuan .Results Totally 525 941 blood samples were screened . The TSH concentration showed a skewed distribution .Among them 525 554 newborns were normal , 230 neonates were diagnosed with CH , and 157 with high TSH hyperlipidemia . When the positive cut-off value was 8.0mIU/L and 8.9mIU/L, the sensitivity χ2 was 10.188 （ P 〈0.05 ） and the specificity χ2 was 458.460 （P〈0.05）.The cut-off value of screening was 8.0mIU/L by DELFIA in the Centre of Neonatal Screening of Sichuan . Conclusion The cut-off value determined by the Centre of Neonatal Screening of Sichuan is reasonable , and it provides an important basis for future CH screening in greater size .

关 键 词：新生儿 先天性甲状腺功能减低症 筛查 切值 

分 类 号：R722[医药卫生—儿科]