中国医药科学2024,Vol.14Issue(1) :138-141.DOI:10.20116/j.issn2095-0616.2024.01.32

新生儿先天性肾上腺皮质增生症筛查切值的影响因素分析

Analysis of influencing factors on screening cut-off value of congenital adrenal hyperplasia in neonates

欧阳嘉颖 周远青 钟华 何思玲 谭伊丽 肖林武
中国医药科学2024,Vol.14Issue(1) :138-141.DOI:10.20116/j.issn2095-0616.2024.01.32

新生儿先天性肾上腺皮质增生症筛查切值的影响因素分析

Analysis of influencing factors on screening cut-off value of congenital adrenal hyperplasia in neonates

欧阳嘉颖 1周远青 1钟华 1何思玲 1谭伊丽 1肖林武1
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作者信息

  • 1. 广东医科大学顺德妇女儿童医院 顺德区妇幼保健院,广东佛山 528300
  • 折叠

摘要

目的 探讨新生儿先天性肾上腺皮质增生症筛查切值的影响因素.方法 选取 2020 年 8 月至 2021 年10 月广东医科大学顺德妇女儿童医院收治的 171 例活产新生儿深入分析,采集足跟血测定 17-羟孕酮(17-OHP)浓度,分析不同胎龄、体重对 17-OHP产生的影响,并计算其截断值.结果 初筛阳性为 51 例,早产儿与足月儿分别为 41 例(80.39%)、10 例(19.61%),其中复查阳性者有 24 例.不同胎龄新生儿中,早产儿 17-OHP浓度更高,差异有统计学意义(P<0.05);不同出生体重新生儿中,低出生体重儿 17-OHP浓度更高,差异有统计学意义(P<0.05).通过多元线性回归分析发现,新生儿胎龄、出生体重是影响 17-OHP浓度水平的危险因素,胎龄对17-OHP浓度水平负向影响更为明显,差异有统计学意义(P<0.05).与试剂盒筛查相比,P99.9 百分位数法早产儿筛选率更低,差异有统计学意义(P<0.05).结论 胎龄、出生体重与 17-OHP浓度水平密切相关,可依据胎龄建立 17-OHP截断值,且假阳性率明显降低.

Abstract

Objective To explore the influencing factors on screening cut-off value of congenital adrenal hyperplasia in neonates.Methods A total of 171 live-born neonates admitted to Shunde Women and Children's Hospital of Guangdong Medical University from August 2020 to October 2021 were selected for in-depth analysis.Their heel blood were collected to measure the concentration of 17-hydroxyprogesterone(17-OHP),the effects of different gestational ages and body masses on the generation of 17-OHP were analyzed,and the cut-off value was calculated.Results 51 cases were positive in the preliminary screening,with 41 cases(80.39%)of premature infants and 10 cases(19.61%)of full-term infants,respectively.Among them,24 cases were positive in the re-examination.Among children with different gestational ages,premature infants have higher concentrations of 17-OHP,with the difference was statistically significant(P<0.05).Among children with different birth weights,the concentrations of 17-OHP were higher in low birth weight infants,with the difference was statistically significant(P<0.05).Through multiple linear regression analysis,it was found that gestational age,birth weights were risk factors affecting 17-OHP concentration levels.The negative impact of gestational age on 17-OHP concentration levels was more significant,with the difference was statistically significant(P<0.05).Compared with kit screening,the 99.9th percentile(P99.9)screening rate of premature infants was lower,with the difference was statistically significant(P<0.05).Conclusion Gestational age and birth weights are closely related to 17-OHP concentration levels,thus the 17-OHP cut-off value can be established based on gestational age,and the false positive rate can be significantly reduced.

关键词

新生儿/先天性肾上腺皮质增生症/切值/胎龄/体重/影响因素

Key words

Neonates/Congenital adrenal hyperplasia/Cut-off value/Gestational age/Body mass/Influencing factors

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基金项目

2020年佛山市自筹经费类科技计划项目(医学类科技攻关项目)(2020001005293)

出版年

2024
中国医药科学
海峡两岸医药卫生交流协会 二十一世纪联合创新(北京)医药科学研究院

中国医药科学

影响因子:1.083
ISSN:2095-0616
参考文献量14
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