Słuszniak Aleksandra, Kurtyka Zuzanna, Lemańska Dorota
Pracownia Badań Przesiewowych i Błedów Metabolicznych, Uniwersytecki Szpital Dzieciecy w Krakowie.
Przegl Lek. 2011;68(1):59-62.
The objective of neonatal mass screening programs that are obligatory in Poland is an early detection of congenital diseases: hypothyreosis, phenylketonuria and cystic fibrosis. Cystic fibrosis is the most common genetic monogenic disease affecting Caucasian individuals and having an autosomal recessive inheritance pattern. Neonatal screening for cystic fibrosis allows for diagnosing the disease in the first month of life and early introduction of preventive-therapeutic management. In the period between June 1, 2009 and July 31, 2010, a total of 82,250 newborns were screened in the Krakow mass screening lab.
Determinations of immunoreactive tripsin (IRT) by ELISA, and DNA analysis (searching for mutations in the CFTR gene by sequencing) if IRT was above 99.4 centile in blood on filter paper. The incidence of cystic fibrosis in south-east Poland was determined as 1:7,477, and carriership as 1:2,006. Of newborns with confirmed cystic fibrosis, five presented with signs of malnutrition, edemas, intrahepatic cholestasis and anemia. Almost all of these children passed fatty stools. Two were diagnosed with active CMV infections.
波兰实施的新生儿群体筛查项目的目标是早期发现先天性疾病:甲状腺功能减退症、苯丙酮尿症和囊性纤维化。囊性纤维化是影响白种人最常见的单基因遗传病,具有常染色体隐性遗传模式。新生儿囊性纤维化筛查可在出生后第一个月诊断出该疾病,并尽早引入预防性治疗管理。在2009年6月1日至2010年7月31日期间,克拉科夫群体筛查实验室共对82250名新生儿进行了筛查。
采用酶联免疫吸附测定法(ELISA)测定免疫反应性胰蛋白酶(IRT),如果滤纸血样中IRT高于第99.4百分位数,则进行DNA分析(通过测序寻找CFTR基因中的突变)。波兰东南部囊性纤维化的发病率确定为1:7477,携带者率为1:2006。在确诊为囊性纤维化的新生儿中,有5名出现营养不良、水肿、肝内胆汁淤积和贫血症状。几乎所有这些儿童都有脂肪便。两名儿童被诊断为活动性巨细胞病毒感染。
1)新生儿群体筛查可早期发现囊性纤维化并引入适当的治疗管理(通过提供适量蛋白质、必需脂肪酸、胰酶以及补充维生素A和E来预防营养不良)。2)基因检测结果出来后,立即召回儿童进行诊断核实,这最大程度地缩短了确诊疾病所需的时间。