广州市新生儿先天性促甲状腺素筛查切值的建立和探讨

目的 探讨广州地区新生儿先天性促甲状腺素的水平分布并建立本地区的筛查实验切值。方法 对广州市2011年9月-2012年8月间209 534例新生儿先天性甲状腺功能低下筛查的结果进行统计,使用百分位数法及ROC曲线计算促甲状腺素(thyroid stimulating hormone,TSH)参考切值,并结合实际筛查工作确定合理的切值。结果 新生儿疾病筛查TSH水平呈偏态分布,TSH水平P₉₉为9.63 mU/L,ROC曲线计算的最佳TSH值为14 mU/L,最终确定的TSH低切值为9 mU/L,高切值为25 mU/L。 结论 在开展筛查工作之前必须根据本地区的实际情况确立适宜的切值,确立高低两个切值并建立不同的召回方式对甲低筛查工作是合理有效的模式。

Establishment the cut-off value of congenital hypothyroidism on newborn in Guangzhou city

Objective To get the distribution of thyroid stimulating hormone (TSH) and cut-off value in Guangzhou city. Method The results of 209 534 newborns were analysed from September 2011 to August 2012,which was described by percentiles and ROC curve,and determined the reasonable cut-off value combined with the actual screening results. 【Result】 The distribution of newborn screen was deflection,P₉₉ was 9.63 mU/L,the optimal cut-off value was 14 mU/L by ROC curve,the low cut-off value of our lab was 9 mU/L and the high cut-off value was 25 mU/L. Conclusion It is necessary to establish the reasonable cut-off value before carring out the neonatal screening.The determination of low and high cut-off value and establishment of recall-back methods are effective mode for neonatal screening.