新生儿先天性肾上腺皮质增生症筛查切值的影响因素分析  

Analysis of influencing factors on screening cut-off value of congenital adrenal hyperplasia in neonates

作　　者：欧阳嘉颖 周远青 钟华 何思玲 谭伊丽 肖林武 OUYANG Jiaying;ZHOU Yuanqing;ZHONG Hua;HE Siling;TAN Yili;XIAO Linwu(Shunde Women and Children’s Hospital of Guangdong Medical University,Maternity&Child Healthcare Hospital of Shunde Foshan,Guangdong,Foshan 528300,China)

机构地区：[1]广东医科大学顺德妇女儿童医院顺德区妇幼保健院,广东佛山528300

出　　处：《中国医药科学》2024年第1期138-141,共4页China Medicine And Pharmacy

基　　金：2020年佛山市自筹经费类科技计划项目(医学类科技攻关项目)(2020001005293)。

摘　　要：目的探讨新生儿先天性肾上腺皮质增生症筛查切值的影响因素。方法选取2020年8月至2021年10月广东医科大学顺德妇女儿童医院收治的171例活产新生儿深入分析,采集足跟血测定17-羟孕酮(17-OHP)浓度,分析不同胎龄、体重对17-OHP产生的影响,并计算其截断值。结果初筛阳性为51例,早产儿与足月儿分别为41例(80.39%)、10例(19.61%),其中复查阳性者有24例。不同胎龄新生儿中,早产儿17-OHP浓度更高,差异有统计学意义(P<0.05);不同出生体重新生儿中,低出生体重儿17-OHP浓度更高,差异有统计学意义(P<0.05)。通过多元线性回归分析发现,新生儿胎龄、出生体重是影响17-OHP浓度水平的危险因素,胎龄对17-OHP浓度水平负向影响更为明显,差异有统计学意义(P<0.05)。与试剂盒筛查相比,P99.9百分位数法早产儿筛选率更低,差异有统计学意义(P<0.05)。结论胎龄、出生体重与17-OHP浓度水平密切相关,可依据胎龄建立17-OHP截断值,且假阳性率明显降低。Objective To explore the influencing factors on screening cut-off value of congenital adrenal hyperplasia in neonates.Methods A total of 171 live-born neonates admitted to Shunde Women and Children’s Hospital of Guangdong Medical Univers ity from August 2020 to October 2021 were s elected for in-depth analysis.Their heel blood were collected to measure the concentration of 17-hydroxyprogesterone(17-OHP),the effects of different gestational ages and body masses on the generation of 17-OHP were analyzed,and the cut-off value was calculated.Results 51 cases were positive in the preliminary screening,with 41 cases(80.39%)of premature infants and 10 cases(19.61%)of full-term infants,respectively.Among them,24 cases were positive in the reexamination.Among children with different gestational ages,premature infants have higher concentrations of 17-OHP,with the difference was statistically significant(P<0.05).Among children with different birth weights,the concentrations of 17-OHP were higher in low birth weight infants,with the difference was statistically significant(P<0.05).Through multiple linear regression analysis,it was found that gestational age,birth weights were risk factors affecting 17-OHP concentration levels.The negative impact of gestational age on 17-OHP concentration levels was more significant,with the difference was statistically significant(P<0.05).Compared with kit screening,the 99.9th percentile(P99.9)screening rate of premature infants was lower,with the difference was statistically significant(P<0.05).Conclusion Gestational age and birth weights are closely related to 17-OHP concentration levels,thus the 17-OHP cut-off value can be established based on gestational age,and the false positive rate can be significantly reduced.

关 键 词：新生儿 先天性肾上腺皮质增生症 切值 胎龄 体重 影响因素 

分 类 号：R722.1[医药卫生—儿科]