摘要
目的了解四川省新生儿疾病筛查中心先天性甲状腺功能减低症(CH)的促甲状腺素(TSH)季节变化并确定切值,减少漏诊率、降低假阳性率。方法选取该中心2015年1月至2016年12月共计536040例新生儿足跟血标本,采用时间分辨荧光法检测其TSH浓度,将检测结果按照季节分组,用百分位数法计算切值并进行试验评价。结果共确诊患儿256例,其中CH196例、高TSH血症60例。春、夏、秋、冬季TSH水平的P99値分别为8.4μU/mL、6.3μU/mL、6.1μU/mL、7.9μU/mL,全年的为7.4μU/mL。使用Kruskal-Wallis单因素ANOVA检验比较春夏秋冬季TSH含量水平,差异有统计学意义(P<0.05)。将春季和冬季检测结果合并,得其P99値为8.2μU/mL,夏季和秋季检测结果合并,得其P99値为6.3μU/mL。使用Mann-Whitney U检验比较春冬季和夏秋季TSH含量水平,差异有统计学意义(P<0.05)。结论 TSH筛查切值存在季节和温度差异,春冬季宜使用低温切值8.0μU/mL,夏秋季宜使用高温切值6.3μU/mL。
Objective To investigate the seasonal variation of thyroid stimulating hormone(TSH)in congenital hypothyroidism(CH)in neonatal screening center of Sichuan Province,and to determine the cut-off value,reduce the rate of missed diagnosis and reduce the false positive rate.Methods A total of 536040 neonatal heel blood samples were selected from January 2015 to December 2016.The TSH concentration was detected by time-resolved fluorescence method.The results were grouped according to the season,and the percentile method was used to calculate the cut value and evaluate the results.Results A total of 256 children were diagnosed as CH196 and 60cases of high TSH.Spring,summer,autumn and winter TSH level P99 value were 8.4μU/mL,6.3μU/mL,6.1μU/mL,7.9μU/mL,7.4μU/mL of the year.Kruskal-Wallis single factor ANOVA test was used to compare the content of TSH in spring,summer,autumn and winter,and the difference was statistically significant(P<0.05).The spring and winter detection results merging,the P99 value is 8.2μU/mL;summer and fall detection results merging,the P99 value is 6.3μU/mL.Mann-Whitney U test was used to compare the content of TSH in spring,winter and summer and autumn,and the difference was statistically significant(P<0.05).Conclusion There are seasonal and temperature differences in TSH screening.In spring and winter,it is appropriate to use a low temperature cut value of 8.0μU/mL in spring and winter.In summer and autumn season,it is suitable to use high temperature to cut the value of 6.3μU/mL.
作者
杨丽涓
欧明才
张钰
胡琦
周婧瑶
陈雪莲
苏星月
YANG Li-juan;OUMing-cai;ZHANG Yu(Sichuan Maternity and Child Health Care Hospital ,Chengdu 610045 ,China)
出处
《中国实验诊断学》
2019年第1期16-19,共4页
Chinese Journal of Laboratory Diagnosis
