新生儿疾病筛查临界值选取与筛查效率.pdfVIP

· 48· 中国妇幼保健20o8年第23卷 · 儿童保健· 新生儿疾病筛查临界值选取与筛查效率 胡唏江 索庆丽 陈 黄 睿 埘 婷 湖北省武汉市妇幼保健院 430016 中国图书分类号 m74 文献标识码 B 文章编号 1001-4411(2008)01-0048-03 【摘 要】 目的：探讨武汉市新生儿疾病筛查临界值选取方法和运用此临界值的筛查效果，总结经验、提高筛查效率，降 低漏诊率。方法：新生儿出生后72 h，采足跟末稍血制成滤纸干血片，用FEIA法检测血片中TSH和Phe含量，根据季节和标本 采集时间选择不同临界值，并将初筛阳性新生儿召回确诊。结果；5年来，共筛查新生儿137 826例，使用新临界值后，CH和 PKU初筛阳性率由7．14％o和1．27％o增加到9．98％o和1．99‰，同时，CH和PKU发病率分别由0．49‰和0．60／万提高到0．78％o和 1．05／万。结论：新生儿疾病筛查实验室应根据自身实际情况，制定适合本地区临界值，最大限度地减少漏诊，同时，避免过高 假阳性给社会带来的负担，实验室要加强全面质量控制，推动新生儿疾病筛查工作向深层次发展。 【关键词】 新生儿 疾病筛查 临界值 效率 Explore for cut——off point choosing and efficiency on newborn disease screening HU Xi— ，XUO Q 一Li，CHEN Qi，et a1．Wuhan Women and Children Healthcare Hospital，Wuhan 430016， Hubei．China [Abstract] Objective：To explore the method of choosing cut—off point and its effect on neonate disease screening practice in Wu- han，to impmve screening efficiency and lower leak of positive case maximumly．Methods：A drop of plantar blood from newborns 72 hours after delivery was obtained onto a filter paper and dried to test blood levels of TSH and Phc by FEIA method．The different cut—off points were choosed based on the season and time when the specimen being taken，and the positive cases were recalled for further comfiring．Results：The CH screen positive rate rised from 7．14％o to 9．98％o while PKU from 1．27％o to 1．99％o for 5 years，total 137 826 cases were screened by the new cut—off point．the morbidity of CH and PKU changed from 0．49‰ and 0．60／104 to 0．78％o and 1．05／ 104 respectively．Conclusion：The cut—off point should be made by a laboratory based on its chracteristics so as to reduce maximumly t}le leaking．At the same time，the laboratory must strengthen the total Quality Control for avoiding high false positive for which may bring excess society bur