安庆市新生儿先天性甲状腺功能减退症TSH筛查切值探讨

Study on screening cut-off points of the thyroid-stimulating hormone in Anqing

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 know the distribution of TSH and incidence of neonatal congenital hypothyroidism（CH）,and study the screening cut-off points of the thyroid-stimulating hormone（TSH）in Anqing. Methods The neonatal screening data about 59 295 newborns in Anqing were analyzed and the TSH cut-off points were calculated by method of percentiles and Receiver Operating Characteristic（ROC）curve,then,the incidence of sufferers was analyzed by different cut-off points. Results The distribution of the neonatal screening data was deflection,P50 was 2.52mU/L,P99 was 8.94mU/L.Combined with ROC curve,the cut-off points of our lab was 8.12mU/L. Conclusions Different cut-off points effect the consequences of the neonatal screening.It is important to establish the suitable cut-off points with ROC curve based on lab.