孕周体重和采血时间对新生儿CAH筛查中17羟孕酮切值的影响分析  

An Analysis of the Effects of Gestational Age,Birth Weight and Age at Sampling on the 17-Hydroxyprogesterone Cut-off Values for CAH Neonatal Screening

作　　者：万智慧[1] 于璐[1] 简永建 李艳霞[1] 刘伟[1] 马志军[1] WAN Zhihui;YU Lu;JIAN Yongjian;LI Yanxia;LIU Wei;MA Zhijun(Department of Clinical Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University,Beijing Maternal and Child Health Care Hospital, Beijing 100026, China)

机构地区：[1]首都医科大学附属北京妇产医院,北京妇幼保健院检验科,北京100026

出　　处：《标记免疫分析与临床》2020年第5期786-789,共4页Labeled Immunoassays and Clinical Medicine

基　　金：首都医科大学基础-临床科研合作基金(编号:17JL58)。

摘　　要：目的分析不同孕周、体重和采血时间对新生儿先天性肾上腺皮质增生症(congenital adrenal hyperplasia,CAH)筛查中17羟孕酮(17-OH-progesterone,17-OHP)切值的影响。方法回顾性分析2019年1月至2019年8月北京市新生儿疾病筛查中心筛查的新生儿样本共141465例,采用时间分辨荧光免疫分析方法检测新生儿干血滤纸片中17-OHP的水平,按照孕周、体重和采血时间进行分组统计分析,以99.5%百分位数来设置初始切值。结果17-OHP的水平在不同孕周组、不同体重组和不同采血时间组均有显著差异,17-OHP水平与孕周的相关性比体重更大。结论不同孕周、体重和采血时间均显著影响17-OHP的水平,应根据孕周和采血时间调整、优化17-OHP的切值以提高新生儿CAH筛查的效率。Objective To analyze the effects of gestational age(GA),birth weight(BW)and age at sampling on the 17-hydroxyprogesterone cut-off values for CAH neonatal screening.Methods The 17-OHP concentrations in dried blood spots were measured by time-resolved immunofluorescence and were grouped according with gestational age(GA),birth weight(BW)and age at sampling for 141465 newborns.The 99.5th percentile was used to set the initial cut-off value as a reference.Results Significant differences in 17-OHP concentrations were observed among newborns with different GAs,BWs and sampling age.A stronger correlation was observed between GA and 17-OHP concentration than between BW and 17-OHP concentration.Conclusion GA,BW and sampling age have influences on the concentration of 17-OHP.The efficiency of CAH neonatal screening can be substantially improved by adjusting the multitier cut-off value according to GA and age at sampling.

关 键 词：孕周 体重 采血时间 17羟孕酮 先天性肾上腺皮质增生症 

分 类 号：R722.11[医药卫生—儿科]