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目的分析广西地区新生儿促甲状腺素(TSH)的水平分布,建立广西地区新生儿先天性甲状腺功能减低症(CH)的筛查切值,并对切值进行评估及修正。方法对本筛查中心2009年-2013年新生儿先天性甲状腺功能减低症筛查数据进行统计,使用百分位数法和ROC曲线来计算TSH参考切值,根据确诊患者情况及在不同切值条件下检测结果的准确性、成本效益问题等多方面综合考虑对切值进行评估。结果新生儿TSH检测水平呈偏态分布,TSH水平P99为8.6mU/L,ROC曲线计算出参考切值为7.99mU/L,最终确定的切值为8.0mU/L。结论各地区实验方法、地域环境及人群分布不同,TSH水平分布存在差异性,建立适合本地区的切值可为新生儿CH筛查工作的开展提供科学依据。
Objective To analyze the distribution of thyroid-stimulating hormone (TSH) levels in neonates in Guangxi and to establish a screening cut-off value for neonatal congenital hypothyroidism (CH) in Guangxi. The cut-off value was evaluated and corrected. Methods The screening data of congenital hypothyroidism (Hypothyroidism) in neonatal screening center in this screening center from 2009 to 2013 were calculated. The TSH reference cut-off value was calculated by using the percentile method and the ROC curve. According to the diagnosed patients and the conditions of different cut-values Under the accuracy of the test results, cost-effectiveness and many other aspects to consider the cut value assessment. Results The level of TSH in neonates was skewed. The TSH level P99 was 8.6 mU / L. The ROC curve calculated the reference cut value of 7.99 mU / L and the final cut-off value was 8.0 mU / L. Conclusion There are differences in the distribution of TSH in different regions in terms of experimental methods, geographical environment and population distribution. Establishing a cut-off value suitable for this region may provide a scientific basis for the development of CH screening in neonates.