[1]唐苗苗,白 洁,李 佳,等.我院新生儿17α-羟孕酮筛查结果分析[J].医学信息,2021,34(16):152-154.[doi:10.3969/j.issn.1006-1959.2021.16.043]
　TANG Miao-miao,BAI Jie,LI Jia,et al.Analysis of the Screening Results of Neonates with 17α-hydroxyprogesterone in Our Hospital[J].Medical Information,2021,34(16):152-154.[doi:10.3969/j.issn.1006-1959.2021.16.043]
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我院新生儿17α-羟孕酮筛查结果分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年16期
页码:
152-154
栏目:
调查分析
出版日期:
2021-08-15

文章信息/Info

Title:
Analysis of the Screening Results of Neonates with 17α-hydroxyprogesterone in Our Hospital
文章编号:
1006-1959（2021）16-0152-03
作者:
唐苗苗; 白 洁; 李 佳; 等
（空军军医大学第一附属医院妇产科，陕西 西安 710032）
Author(s):
TANG Miao-miao; BAI Jie; LI Jia; et al.
(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Air Force Military Medical University, Xi’an710032,Shaanxi,China)
关键词:
先天性肾上腺皮质增生症; 胎龄; 出生体重; 假阳性率
Keywords:
Congenital adrenal hyperplasia; Gestational age; Birth weight; False positive rate
分类号:
R722.1
DOI:
10.3969/j.issn.1006-1959.2021.16.043
文献标志码:
A
摘要:
目的 分析我院新生儿17α-羟孕酮（17-OHP）的筛查结果，了解新生儿先天性肾上腺皮质增生症（CAH）发病率及17-OHP与出生体重和孕周的相关性，并建立更合理的切值。方法 选择2017年4月~2019年12月在我院出生的新生儿作为研究对象，采集足跟血以时间分辨荧光分析法进行17-OHP检测，根据新生儿出生体重和孕周分为：低体重早产儿、正常体重早产儿、低体重足月儿及正常体重足月儿，分析不同新生儿17-OHP浓度分布情况，并分析体重和孕周与17-OHP浓度的相关性，采用百分位数法确定实验切值，统计召回率。结果 共筛查22,940例新生儿，CAH阳性率为0.86%，确诊CAH1例为失盐性，发病率为0.0043%；17-OHP浓度和新生儿出生体重及孕周均呈负相关（r=-0.18、-0.27，P＜0.05）；不同出生体重和孕周新生儿的99百分位数切值存在差异：低体重早产儿99百分位数值为68.2 nmol/L，正常体重早产儿99百分位数值为34.1 nmol/L，低体重足月儿99百分位数值为28.1 nmol/L，正常体重足月儿99百分位数值为24.9 nmol/L；若采用99百分位数为切值，则低体重早产儿、正常体重早产儿的召回率略有降低，低体重足月儿召回率不变，正常体重足月儿的召回率略有升高。结论 新生儿17-OHP浓度与出生体重和孕周呈负相关；因此，采用同一切值并不合理，建议应根据新生儿出生体重和孕周进行分组，建立不同的切值，减少假阳性率和召回率，提高筛查效率。
Abstract:
Objective To analyze the screening results of neonatal 17α-hydroxyprogesterone (17-OHP) in our hospital, to understand the incidence of neonatal congenital adrenal hyperplasia (CAH) and the correlation between 17-OHP and birth weight and gestational age, and explore the establishment of a more reasonable cut value.Methods Newborns born in our hospital between April 2017 and December 2019 were selected as the research object, and heel blood was collected for 17-OHP detection by time-resolved fluorescence analysis.According to the newborn’s birth weight and gestational week, it was divided into: low-weight premature infants, normal-weight premature infants, low-weight term infants and normal-weight term infants.Analyze the distribution of 17-OHP concentration in different newborns, and analyze the correlation between body weight and gestational age and 17-OHP concentration, use percentile method to determine the experimental cut-off value, and calculate the recall rate.Results A total of 22,940 newborns were screened. The positive rate of CAH was 0.86%. 1 case of CAH was diagnosed as salt loss, and the incidence rate was 0.0043%. The concentration of 17-OHP was negatively correlated with newborn birth weight and gestational age (r=-0.18, -0.27, P＜0.05);There were differences in the 99th percentile cut-off value of newborns with different birth weights and gestational weeks: the 99th percentile value of low birth weight preterm infants was 68.2 nmol/L,the 99th percentile value of normal-weight preterm infants was 34.1 nmol/L, the 99th percentile value of low-weight term infants was 28.1 nmol/L, and the 99th percentile value of normal-weight term infants was 24.9 nmol/L;If the 99 percentile was used as the cut-off value, the recall rate of low-weight preterm infants and normal-weight preterm infants would be slightly reduced, the recall rate of low-weight term infants would remain unchanged, and the recall rate of normal-weight term infants would slightly increase high.Conclusion The neonatal 17-OHP concentration is negatively correlated with neonatal birth weight and gestational age;Therefore, it is unreasonable to use the same value. It is recommended to group the newborns according to the birth weight and gestational age, establish different cut-off values, reduce the false positive rate and the recall rate, and improve the screening efficiency.

参考文献/References:

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更新日期/Last Update: 1900-01-01