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目的分析苏州市2015年6月~2017年1月新生儿先天性甲状腺功能减低症(congenital hypothyroidism,CH)筛查工作结果,探讨建立苏州市筛查CH促甲状腺素(TSH)切值的方法。方法采集新生儿足跟血滤纸标本,采用时间分辨荧光免疫法(DELFIA)Perkin·Elmer试剂盒检测滤纸干血斑中TSH的浓度。采用百分位数法和ROC曲线建立TSH筛查切值。结果 213 367例新生儿TSH筛查结果呈偏态分布,确诊患儿134例。以99%的百分位数为切值和试剂盒建议的9μU/ml为切值分别造成7例患儿和8例CH患儿漏筛。ROC曲线法得到的切值7.07μU/ml约登指数最高,无漏筛情况。结论苏州市CH发病率高于全国平均水平,TSH筛查切值7μU/ml比较适合苏州人群。
Objective To analyze the screening results of congenital hypothyroidism (CH) in neonates from June 2015 to January 2017 in Suzhou City, and to explore the method of screening TSH value in Suzhou City. Methods Neonatal heel blood filter paper samples were collected and the concentration of TSH in the dried blood spots of the filter paper was detected by the time-resolved fluorescence immunoassay (DELFIA) Perkin Elmer kit. TSH screening cut-off values were established using the percentile method and ROC curve. Results 213 367 newborns TSH screening results were skewed distribution, diagnosed 134 cases of children. A cut-off value of 99% for the percentile and 9μU / ml for the kit suggested that 7 patients and 8 CH children, respectively, had missed the screen. ROC curve obtained cut value 7.07μU / ml Youden index highest, no leakage sieve situation. Conclusion The incidence of CH in Suzhou City is higher than the national average. The TSH screening cut-off value of 7μU / ml is more suitable for Suzhou population.