新生儿脐血和足跟血TSH水平的比较

COMPARISON OF CORD AND HEEL BLOOD THYROIDSTIMULATING HORMONE LEVELS IN NEONATES

为了评价脐血和足跟血用于甲状腺功能减退(甲减)筛查的效果,对同一新生儿配对收集其脐血和足跟血,比较TSH水平。用高灵敏度的免疫放射分析法(IRMA)检测1998例新生儿血斑样品的TSH。出生后1～3天的足跟血均值高于脐血均值,而4～8天时则相反。从频数分布可见生后2天内的足跟血中TSH增高者较脐血多,而3～4天时二者较接近。提示甲减筛查时脐血和足跟血均可使用,而脐血可能较生后2天内的足跟血更好。

To evaluate the sampling methods for screening neonatal hypothyroidism, we compared cord and heel blood specimens of the same baby. A total of 1 998 pairs of neonatal blood spots TSH values were determined by a highly senstive immunoradiometric assay (IRMA). The results showed that from 1 to 3 days of age, mean TSH values in heel blood were higher than those in cord blood and from 4 to 8 days of age, the values in the former were lower than in the latter. The distribution showed a higher proportion of heel blood samples with raised TSH levels as compared with cord blood when the specimens were collected within 2 days after birth. The distributions were very similar between cord and heel blood samples collected from babies of 3 and 4 days old. Our results indicated that cord blood as well as heel blood can be used for neonatal screening and the former may be better than heel blood collected within 2 days after birth.