武汉地区季节和温度对新生儿促甲状腺激素的影响及分析

To analyze the effects of season and temperature on neonatal thyroid stimulating hormone in Wuhan

目的分析武汉地区季节和温度对新生儿促甲状腺激素(TSH)水平、筛查阳性率和阳性预测值(PPV)的影响。方法收集56924例新生儿滤纸干血斑TSH的筛查数据和确诊数据,以及研究时间段内每日平均温度,并按气温法划分季节。分析季节和温度与TSH水平的关系,温度与筛查阳性率及PPV的关系。结果TSH水平在冬季达到顶峰,在夏季达到低谷,并且冬季的TSH水平分布较夏季分散。春、夏、秋、冬季TSH水平中位数分别为3.79、2.82、3.39、4.06mU/L,春、夏、秋、冬四组间的TSH水平均有显著性的差异(P<0.01)。TSH水平中位数与日平均温度呈负相关(r=–0.773,P<0.01)。月平均温度与筛查阳性率呈负相关(r=–0.881,P<0.01),与PPV呈正相关(r=0.728,P<0.01)。结论TSH水平变化受到季节和温度显著的影响,根据季节温度的变化设立精准的TSH切值可以有效减少假阳性率,减轻了家长的精神负担。

Objective To analyze the effects of season and temperature on the thyroid stimulating hormone(TSH)value,screening positive rate and positive predictive value(PPV)among neonates in Wuhan.Methods To collect the 56924 dried blood spot data and the confirmatory data of TSH,as well as the daily average temperature during the study period,then divided into four seasons according to the National Weather Service.To analyze the relationship between season and temperature and TSH,the relationship between temperature and screening positive rate and PPV.Results TSH appeared to peak in winter and troughed in summer,the distribution of TSH in winter was more dispersed than in summer.The median TSH values during spring,summer,autumn and winter were 3.79,2.82,3.39,and 4.06 mU/L.There were significant differences in TSH among the four groups(P<0.01).The median TSH values showing a negative correlation with the daily mean temperature(r=-0.773,P<0.01).Monthly mean temperature was negatively correlated with screening positive rate(r--0.881,P<0.01),and positively correlated with PPV(r=0.728,P<0.01).Conclusion The variations in TSH values are significantly affected by seasons and temperature.Establishing accurate TSH cut-off values according to the changes of seasons and temperature can effectively reduce the false positive rate and reduce the mental burden of parents.