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目的建立本地区先天性甲状腺功能减低症(CH)的筛查阳性切值。方法对2010年7月至2011年7月全市120余家分娩机构分娩的47066例新生儿进行CH筛查,采足跟末稍血制成滤纸干血片,用DELFIA法检测干血片中TSH含量,对筛查阳性结果召回确诊。结果筛查阳性切值为9.0μIU/mL时,筛查灵敏度、特异度和漏诊率分别为:100%,99.53%,0%;通过百分位数法统计分析,99%可信限浓度8.52μIU/mL;8.0-9.0μIU/mL之间召回的23例新生儿中发现9例高TSH血症患者,其初筛TSH浓度下限为8.61μIU/mL。结论为了提高筛查效率,防止漏诊的发生,同时加强对高TSH血症患者的随访,本地区新生儿先天性甲状腺功能低下症筛查的阳性切值调整为8.50μIU/mL。
Objective To establish a positive screening test for congenital hypothyroidism (CH) in this region. Methods From July 2010 to July 2011, 47066 newborn babies delivered in more than 120 delivery institutions in the city were screened for CH. Dry blood films of filter paper were collected from the heel and heel, and TSH Content, the positive results of screening for the recall confirmed. Results The sensitivity, specificity and misdiagnosis rate of screening positive screening value were 9.0μIU / mL, respectively: 100%, 99.53%, 0%; by the statistical analysis of the percentile method, the 99% confidence interval concentration was 8.52 9 cases of hypercholesteremia with TSH were found in 23 newborns recalled between 8.0-9.0μIU / mL. The lower limit of initial screening for TSH was 8.61μIU / mL. Conclusion In order to improve screening efficiency, prevent missed diagnosis and enhance follow-up of patients with hyper-TSH, the positive cut-off value of neonatal congenital hypothyroidism screening was adjusted to 8.50μIU / mL.