株洲地区新生儿先天性甲状腺功能减低症筛查TSH切值的建立

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。

Establishment of TSH cut-off point for neonatal congenital hypothyroidism screening in Zhuzhou

Objective: To establish the TSH cut-off point of neonatal congenital hypothyroidism(CH) in Zhuzhou.Methods: 47066 dried blood Samples were collected from more than120 delivery organizations for CH screening.The TSH value on the filter paper was measured by DELFIA method.Finally,the positive newborns were recalled for further confirming.Results: when the cut-off point is 9μIU/mL,the sensitivity is 100%,specificity is 99.53%,and no positive newborns was missed;while think about the 99%confidence interval according to percentile method,the cut-off point should be 8.52 μIU/mL;and nine High TSH hematic disease patients were found,whose lowest TSH concentration was 8.61μIU/mL.Conclusion: In order to improve the effect of neonatal congenital hypothyroidism screening,and enforce the recalling of High TSH hematic disease patients,The TSH cut-off point was adjust to 8.5μIU/mL.