足跟血TSH、IGF-1对先天性甲状腺功能减低症的预测价值  

Predictive value of heel blood TSH and IGF-1 for congenital hypothyroidism

作　　者：张玉佩 宋婕 郭爱琳 ZHANG Yupei;SONG Jie;GUO Ailin(Institute of Pediatrics,the Seventh Medical Center of Chinese People′s Liberation Army General Hospital,Beijing 100010,China;Department of Clinical Laboratory,the Fourth Medical Center of Chinese People′s Liberation Army General Hospital,Beijing 100089,China)

机构地区：[1]中国人民解放军总医院第七医学中心儿科研究所,北京100010 [2]中国人民解放军总医院第四医学中心检验科,北京100089

出　　处：《国际检验医学杂志》2025年第1期60-64,共5页International Journal of Laboratory Medicine

摘　　要：目的探究足跟血促甲状腺激素(TSH)、胰岛素样生长因子-1(IGF-1)对先天性甲状腺功能减低症(CH)的预测价值。方法选择2021年1月至2024年1月中国人民解放军总医院第七医学中心收治的83例CH患儿作为研究组,并选择同期在该中心出生及体检的53例健康新生儿作为对照组。两组均测定足跟血TSH、IGF-1,同时测定甲状腺功能指标。比较两组足跟血TSH、IGF-1与甲状腺功能指标,分析足跟血TSH、IGF-1与甲状腺功能指标相关性,分析CH发生的影响因素,以及足跟血TSH、IGF-1及甲状腺指标对CH的预测价值。结果研究组儿童TSH较对照组高,而IGF-1、游离甲状腺激素(FT4)、三碘甲状原氨酸(TT3)、甲状腺激素(TT4)、游离三碘甲状腺原氨酸(FT3)较对照组低(P<0.05);Pearson相关性分析显示,足跟血TSH与FT4、TT3、FT3、TT4呈负相关(r=-0.522、-0.468、-0.539、-0.667,均P<0.05),IGF-1与FT4、TT3、FT3、TT4呈正相关(r=0.394、0.427、0.511、0.562,均P<0.05);受试者工作特征曲线分析结果显示,TSH、IGF-1及二者联合用于预测CH发生的曲线下面积分别为0.800、0.794、0.822;单因素与多元Logistic回归分析结果显示,出生时体重、家族史、TSH、IGF-1、FT4、FT3为CH发生影响因素(P<0.05)。结论CH患儿足跟血TSH、IGF-1水平联合检测对CH发生有一定预测极致,可为患儿病情评估提供参考依据。Objective To explore the predictive value of heel blood thyrotropin stimulating hormone(TSH)and insulin-like growth factor-1(IGF-1)for congenital hypothyroidism(CH).Methods A total of 83 children with CH admitted to the Seventh Medical Center of the Chinese People′s Liberation Army General Hospital from January 2021 to January 2024 were selected as the study group,and 53 healthy newborns born and examined in the center during the same period were selected as the control group.Heel blood TSH,IGF-1 and thyroid function were measured in both groups.Heel blood TSH,IGF-1 and thyroid function indexes were compared between the two groups,and the correlation between heel blood TSH,IGF-1 and thyroid function indexes was analyzed,the influencing factors of CH occurrence were analyzed,and the predictive value of heel blood TSH,IGF-1 and thyroid indexes for CH was analyzed.Results Pearson correlation analysis showed that heel blood TSH was negatively correlated with FT4,TT3,FT3 and TT4(r=-0.522,-0.468,-0.539,-0.667,all P<0.05).IGF-1 was positively correlated with FT4,TT3,FT3,TT4(r=0.394,0.427,0.511,0.562,all P<0.05).The results of receiver operating characteristic curve analysis showed that the area under the curve of TSH,IGF-1 and their combination were 0.800,0.794 and 0.822,respectively.Univariate and multiple Logistic regression analysis showed that birth weight,family history,TSH,IGF-1,FT4,FT3 were the influencing factors for the occurrence of CH(P<0.05).Conclusion The combined detection of TSH and IGF-1 levels in heel blood has a certain predictive value for the occurrence of CH,and can provide a basis for the disease assessment of children.

关 键 词：先天性甲状腺功能减低症 足跟血 促甲状腺激素 胰岛素样因子-1 

分 类 号：R725.8[医药卫生—儿科] R446.1[医药卫生—临床医学]