Sanak Marek
Zakład Biologii Molekularnej i Genetyki Klinicznej, II Katedra Chorób Wewngtrznych Uniwersytet Jagielloński Collegium Medicum, Krakowie.
Przegl Lek. 2011;68(1):14-6.
Newborn screening for cystic fibrosis was initiated 35 years ago but the test has been much less established than phenylketonuria or congenital hypothyreosis screening. Among several reasons for continuous discussion on newborn screening for cystic fibrosis, there are evolving methodology and concurrent use of sequential immunoreactive trypsinogen blood assays or their combination with targeted mutation detection. False positive rate is substantial, depending on the method 3 to 24 children have to be re-screened or undergo chloride sweat test for one diagnosis of cystic fibrosis. Early diagnosis of cystic fibrosis saves the patient malnutrition but more evidences are needed to document an impact on pulmonary symptoms progression. Economical balance of newborn screening for cystic fibrosis may be advantageous but no evaluation of this screening on a psychological reception by the society is available. Some effects of the newborn screening on the procreation have been recently recognized suggesting its eugenics interpretation.
囊性纤维化新生儿筛查始于35年前,但该检测远不如苯丙酮尿症或先天性甲状腺功能减退症筛查那样成熟。在关于囊性纤维化新生儿筛查持续讨论的几个原因中,存在不断发展的方法学以及序贯免疫反应性胰蛋白酶原血液检测的同时使用或其与靶向突变检测的联合使用。假阳性率相当高,根据方法的不同,每诊断一例囊性纤维化,需要对3至24名儿童进行重新筛查或进行氯汗液试验。囊性纤维化的早期诊断可使患者避免营养不良,但仍需要更多证据来证明其对肺部症状进展的影响。囊性纤维化新生儿筛查的经济平衡可能是有利的,但目前尚无关于社会对该筛查心理接受度的评估。最近已经认识到新生儿筛查对生育的一些影响,这暗示了其优生学解释。