["在“第一步”计划（IEDE/RJ）中对新生儿筛查血斑样本中用于先天性甲状腺功能减退症诊断的促甲状腺激素临界值的评估"]
[Evaluation of TSH cutoff value in blood-spot samples in neonatal screening for the diagnosis of congenital hypothyroidism in the Programa "Primeiros Passos" - IEDE/RJ].
作者信息
Barone Bianca, Lopes Clarisse Lourandes da Silva, Tyszler Latife Salomão, do Amaral Valéria Borges, Zarur Rosa Helena C, Paiva Valéria Neto, Leite Denise Boechat, Meirelles Ricardo M R
机构信息
Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro, RJ, Brasil.
出版信息
Arq Bras Endocrinol Metabol. 2013 Feb;57(1):57-61. doi: 10.1590/s0004-27302013000100008.
OBJECTIVE
To analyze the confirmed or not-confirmed cases of neonatal screening (CH) screened in the Programa "Primeiros Passos", stratifying them into TSH blood-spot (TSH-BS) ranges.
MATERIALS AND METHODS
To stratify, in ranges of TSH-BS as a function of TSH serum (TSH-S), the cases called for a confirmatory test from January, 2006 to July, 2009.
RESULTS
Around 37% of the confirmed cases (475) showed TSH-F > 9.5 mUi/L, but most of the confirmed cases were in lower TSH-F ranges. Among the unconfirmed cases (4,613), most were found in the lower ranges. There was no TSH-F range exclusive to unconfirmed cases.
CONCLUSION
TSH-BS cutoff value used is crucial in the diagnosis of CH and should be low, even if more confirmatory tests are performed. More studies are needed to determine the best cutoff value of TSH-BS for neonatal screening.
目的
分析在“第一步”计划中筛查的新生儿筛查（先天性甲状腺功能减退症，CH）确诊和未确诊病例，将其按照促甲状腺激素血斑（TSH-BS）范围进行分层。
材料与方法
根据促甲状腺激素血清（TSH-S），将2006年1月至2009年7月期间需要进行确诊试验的病例按照TSH-BS范围进行分层。
结果
约37%的确诊病例（475例）促甲状腺激素血斑（TSH-F）>9.5 mUi/L，但大多数确诊病例处于较低的TSH-F范围内。在未确诊病例（4613例）中，大多数处于较低范围内。未确诊病例没有专属的TSH-F范围。
结论
所使用的TSH-BS临界值在CH诊断中至关重要，应设定得较低，即便要进行更多的确诊试验。需要更多研究来确定用于新生儿筛查的TSH-BS最佳临界值。
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