CAJ | 학술논문

目的：探讨四川省新生儿疾病筛查中心实验室先天性甲状腺功能减低症（ CH）筛查切值，减少漏诊率，降低假阳性率。方法对四川省新生儿疾病筛查中心片区市县2011至2012年活产婴儿出生72小时并充分哺乳6次后取其足跟血，采用时间分辨荧光免疫法检测血中促甲状腺激素（ TSH）浓度。结果2011至2012年度共测定525941例标本，其TSH浓度呈偏态分布，其中正常新生儿人数为525554，确诊CH患儿230例，高TSH血症患儿157例。当筛查切值定为8．0mIU/L和定为8．9mIU/L时，灵敏度χ2＝10．188，P＜0．05；特异度χ2＝458．460，P＜0．05，制定出四川省新生儿疾病筛查中心实验室时间分辨荧光免疫法筛查CH参考切值为8．0mIU/L。结论四川省新生儿疾病筛查中心制定的CH筛查切值是适宜的、有依据的，为更大规模开展的新生儿CH筛查提供了决策依据。
목적：탐토사천성신생인질병사사중심실험실선천성갑상선공능감저증（ CH）사사절치，감소루진솔，강저가양성솔。방법대사천성신생인질병사사중심편구시현2011지2012년활산영인출생72소시병충분포유6차후취기족근혈，채용시간분변형광면역법검측혈중촉갑상선격소（ TSH）농도。결과2011지2012년도공측정525941례표본，기TSH농도정편태분포，기중정상신생인인수위525554，학진CH환인230례，고TSH혈증환인157례。당사사절치정위8．0mIU/L화정위8．9mIU/L시，령민도χ2＝10．188，P＜0．05；특이도χ2＝458．460，P＜0．05，제정출사천성신생인질병사사중심실험실시간분변형광면역법사사CH삼고절치위8．0mIU/L。결론사천성신생인질병사사중심제정적CH사사절치시괄의적、유의거적，위경대규모개전적신생인CH사사제공료결책의거。
Objective To explore the positive cut-off value in neonatal screening for congenital hypothyroidism (CH) in the Centre of Neonatal Screening of Sichuan , so as to improve screening efficiency and reduce false positive rate .Methods DELFIA was applied to detect the concentration of thyroid-stimulating hormone ( TSH) in heel blood samples which were collected from the newborns 72 hours after birth and having drunk enough milk for at least 6 times.These neonates were born in 2011-2012 in counties and cities managed by the Centre of Neonatal Screening of Sichuan .Results Totally 525 941 blood samples were screened . The TSH concentration showed a skewed distribution .Among them 525 554 newborns were normal , 230 neonates were diagnosed with CH , and 157 with high TSH hyperlipidemia . When the positive cut-off value was 8.0mIU/L and 8.9mIU/L, the sensitivity χ2 was 10.188 ( P <0.05 ) and the specificity χ2 was 458.460 (P<0.05).The cut-off value of screening was 8.0mIU/L by DELFIA in the Centre of Neonatal Screening of Sichuan . Conclusion The cut-off value determined by the Centre of Neonatal Screening of Sichuan is reasonable , and it provides an important basis for future CH screening in greater size .