宁波地区新生儿17-羟孕酮筛查的结果分析

Analysis of the screening results of 17-hydroxyprogesterone in neonates in Ningbo

目的通过对新生儿17-羟孕酮(17-OHP)水平的检测,了解宁波地区先天性肾上腺皮质增生症(congenital adrenalhyperplasia,CAH)的发病率及出生体重、胎龄等因素与17-羟孕酮(17-OHP)之间的相关性。方法采用时间分辨荧光免疫分析法对2014年1月-12月宁波地区分娩的新生儿的干血滤纸片标本进行17-OHP检测,高于临界值者进行召回复查和召回确诊。结果共收集88 406例新生儿,筛查总阳性率为0.59%(517/88 406);最终确诊CAH发病率为0.003%(3/88 406)。确诊的CAH病例中,3例均为失盐型。孕周与17-OHP呈负相关(r=-0.28,P<0.05),出生体重与17-OHP呈负相关(r=-0.19,P<0.05)。结论宁波地区的CAH发病率明显低于全国水平。建议根据不同孕周体重分组,采用不同临界值来提高筛查效率。

Objective Through the detection of neonatal 17-hydroxyprogesterone（ 17-OHP） level,to study the correlation of17-OHP with the incidence rate of congenital adrenal hyperplasia（ CAH）,birth weight,gestational age and other factors.Methods 17-OHP detection of dry blood filter paper samples of newborn infants in Ningbo area was performed by time resolved fluorescence immunoassay during January-December in 2014. If the value was higher than the cut-off value,recalling would be done for further check and diagnosis. Results A total of 88 406 neonates were collected. The screening positive rate was 0. 59%（ 517/88 406）. The final diagnosis rate was 0. 003%（ 3/88 406）. 3 cases were salt-wasting type among the diagnosed CAH cases. Gestational age was negatively correlated with 17-OHP（ r =-0. 28,P 0. 05）,and birth weight was negatively correlated with 17-OHP（ r =-0. 19,P 0. 05）. Conclusion The incidence rate of CAH in Ningbo area is significantly lower than that of the whole country. It is suggested to use different values in 17-OHP screening according to different gestational weeks and weights.