Application study of 17-OHP and ACTH combined detection in early diagnosis of congenital adrenocortical hyperplasia in neonates
Objective To evaluate the application value of the serum 17-hydroxyprogesterone(17-OHP)and adrenocorticotropic hormone(ACTH)combined detection in the early diagnosis of congenital adre-nocortical hyperplasia(CAH)in neonates.Methods A total of 38 cases of CAH admitted and treated in this hospital from January 2019 to June 2022 were selected as the experimental group,and 38 cases of neonatal simple hyperbilirubinemia in the same period served as the control group.The clinical data were collected,and the efficiency of the single indicator detection and 2-indicator combined detection of clinical common serum in-dicators such as progesterone(PROG Ⅲ),17-hydroxyprogesterone(17-OHP),adrenocorticotropic hormone(ACTH)and testosterone(TESTO)for the early diagnosis of CAH in neonates was analyzed.Results The levels of serum PROG Ⅲ,17-OHP,ACTH and TESTO were statistically significant between the two groups(P＜0.001);the multi-factor logistic regression analysis showed that PROG Ⅲ,17-OHP and ACTH were the independent influencing factors of neonates suffering from CAH(P＜0.05).The receiver operating character-istic(ROC)curve for single indicator detection and 2-indicator combined detection showed that the area under the curve(AUC)for the 17-OHP+ACTH combined detection was the highest,AUC was 0.954(95％CI 0.906-1.000),the sensitivity was 89.5％and the specificity was 94.7％.Conclusion The levels of PROGⅢ,17-OHP,ACTH and TESTO are significantly increased in children patients with CAH,and the combined detection of 17-OHP and ACTH has a high early diagnostic efficiency for neonatal CAH.
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