【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。更多还原

【Abstract】 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.更多还原