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目的探讨制定合理的本地新生儿促甲状腺素(TSH)筛查切值。方法对本市59 295例新生儿TSH筛查结果进行分析,使用百分位数法及ROC曲线法制定TSH筛查切值。结果新生儿TSH水平呈偏态分布,P25为1.47mU/L,P50为2.52mU/L,P75为3.96mU/L,P95为6.89mU/L,P99为8.94mU/L;ROC曲线法得出本实验室TSH筛查切值为8.12mU/L。按ROC筛查切值诊断22例先天性甲状腺功能减退症(CH)和28例高TSH血症,若按P99和试剂盒给定的切值标准将漏诊CH患儿1例,漏诊率达4.55%。结论选用ROC曲线法确定适宜的TSH切值是提高原发性先天性甲状腺功能减退症筛查质量的重要措施。
Objective To explore the establishment of a reasonable local thyroid stimulating hormone (TSH) screening cut-off value. Methods The TSH screening results of 59 295 neonates in our city were analyzed. The TSH screening cutoff value was established by the method of percentile and ROC curve. Results The TSH level in neonates was skewed, with P25 of 1.47mU / L, P50 of 2.52mU / L, P75 of 3.96mU / L, P95 of 6.89mU / L and P99 of 8.94mU / L. The TSH screening laboratory value of 8.12mU / L. According to the ROC screening cut value diagnosis of 22 cases of congenital hypothyroidism (CH) and 28 cases of high TSH hyperlipidemia, if according to P99 and the kit given cut-off criteria will be missed CH children in 1 case, the rate of missed diagnosis 4.55 %. Conclusions It is an important measure to improve the screening quality of primary congenital hypothyroidism by using the ROC curve method to determine the appropriate TSH value.