广西地区新生儿筛查促甲状腺素的季节变化与切值探讨  

Seasonal variation of TSH in dried blood spot of Guangxi newborns screening and discussion of cut-off value

作　　者：俸诗瀚[1] 吕群[1] 耿国兴[1] 罗超[1] 林彩娟[1] 李旺[1] 林飞[1] 陈少科[1] 

机构地区：[1]广西壮族自治区妇幼保健院遗传代谢中心实验室,广西南宁530003

出　　处：《中国优生与遗传杂志》2014年第11期132-133,55,共3页Chinese Journal of Birth Health & Heredity

基　　金：国家自然科学基金资助项目(81260126);广西自然科学基金资助项目(2012GXNSFAA053174);广西壮族自治区卫生厅重点项目资助课题(重2012025)

摘　　要：目的了解新生儿先天性甲状腺功能减低症(CH)的促甲状腺素(TSH)季节变化和确定切值,对减少漏诊率、降低假阳性率都有重要的意义。方法对219 036例新生儿出生后72h采集足跟血滤纸血片标本,用荧光酶免疫分析法(FEIA)检测血中TSH浓度,将结果按照季节分为4组,用百分位数法计算切值并比较确诊率和假阳性率。结果四季相比,CH的确诊率有差别但无显著性差异(P>0.05)。冬季的假阳性率与其它三季相比均有高度显著性差异(P<0.01);TSH正常水平99%可信限上限春夏秋冬季分别为7.4μIU/m L、6.8μIU/m L、7.2μIU/m L、10.3μIU/m L,全年的为8.2μIU/m L。结论通过分析219036例新生儿滤纸血片促甲状腺素测定结果,TSH正常水平99%可信上限为8.2μIU/m L,而确诊107例先天性甲状腺功能减低症的初筛TSH最低浓度为8.4μIU/m L,故本实验室确定新生儿滤纸血片促甲状腺素的切值为8.0μIU/m L是安全和科学的。Objectives：In order to know the seasonal variation of TSH in newborn CH screening and study the cut-off value,which has significance to decrease false dismissal rate and false positive rate. Methods：The 219 036 neonatal heel blood of postnatal 72 h was dropped on filter paper,FEIA was used to measure TSH in DBS. According to seasons divide the result into four groups,use percentile method to calculate cut-off value and compare positive rate and false positive rate. Results：In different seasons,positive rate of CH is different but has no significance difference（P〈0.05）. In winter,false positive rate has significance difference to other three seasons（P〈0.01）. P99 of TSH in spring,summer,autumn and winter was 7.4μIU/m L,6.8μIU/m L,7.2μIU/m L,10.3μIU/m L. The P99 of TSH in whole year was 8.2μIU/m L. Conclusion：After analyze 219 036 newborns TSH result,P99 of TSH was 8.2μIU/m L,meanwhile the minim level of 107 diagnosis CH was 8.4μIU/m L,so that the cut-off of 8.0μIU/m L was safe and scientific.

关 键 词：新生儿筛查 TSH 季节变化 切值 

分 类 号：R722.1[医药卫生—儿科]