This study was to explore the optimal threshold of thyroid-stimulating hormone(TSH)-stimulated serum thyroglobulin(s-Tg) for patients who were to receive18F-fluorodeoxyglucose(18F-FDG) PET/CT scan owing to clinical su...This study was to explore the optimal threshold of thyroid-stimulating hormone(TSH)-stimulated serum thyroglobulin(s-Tg) for patients who were to receive18F-fluorodeoxyglucose(18F-FDG) PET/CT scan owing to clinical suspicion of differentiated thyroid cancer(DTC) recurrence but negative post-therapeutic 131I whole-body scan(131I-WBS). A total of 60 qualified patients underwent PET/CT scanning from October 2010 to July 2014. The receiver operating characteristic(ROC) curve analyses showed that s-Tg levels over 49 μg/L led to the highest diagnostic accuracy of PET/CT to detect recurrence, with a sensitivity of 89.5% and a specificity of 90.9%. Besides, bivariate correlation analysis showed positive correlation between s-Tg levels and the maximum standardized uptake values(SUVmax) of18F-FDG in patients with positive PET/CT scanning, suggesting a significant influence of TSH both on Tg release and uptake of18F-FDG. So, positive PET/CT imaging is expected when patients have negative 131I-WBS but s-Tg levels over 49 μg/L.展开更多
【目的】分析28~36周早产儿生后3~21 d FT3、FT4、TSH变化的特征。【方法】回顾性分析2018年7月至2019年6月中山大学附属第三医院新生儿科住院的236例28~36周早产儿的临床资料,包括甲状腺功能检查(FT3、FT4和TSH)、胎龄、性别、出生体...【目的】分析28~36周早产儿生后3~21 d FT3、FT4、TSH变化的特征。【方法】回顾性分析2018年7月至2019年6月中山大学附属第三医院新生儿科住院的236例28~36周早产儿的临床资料,包括甲状腺功能检查(FT3、FT4和TSH)、胎龄、性别、出生体质量、出生身长、检查日龄、辅助生殖方式、单胎或多胎、母亲甲状腺疾病和母亲妊娠期糖尿病,比较早产儿3~7 d与8~21 d FT3、FT4和TSH水平的差异;分析影响早产儿FT3、FT4和TSH水平的独立因素;比较不同胎龄早产儿FT3、FT4和TSH水平差异。【结果】早产儿3~7 d FT3水平(3.23±0.54)pmol/L,低于8~21 d的(3.41±0.76)pmol/L,差异有统计学意义(P=0.040);早产儿3~7 d的FT4水平(15.36±3.40)pmol/L,高于8~21 d的(13.20±2.63)pmol/L,差异有统计学意义(P<0.001);3~7 d与8~21 d的TSH分布的差异没有统计学意义(P=0.846);早产儿3~7 d FT3水平受到胎龄的影响(P<0.001),3~7天FT4水平受到胎龄和检查日龄的影响(P<0.001),8~21 d的FT3、FT4水平均受到胎龄和性别的影响(P<0.001、P<0.001);3~7 d、8~21 d的FT3、FT4水平与胎龄为正相关(P<0.001,P<0.001;P<0.001,P=0.001)。【结论】胎龄影响生后3~21 d早产儿的甲状腺功能,胎龄越小,FT3、FT4越低,需要建立一个胎龄相关的的FT4或T4参考范围,结合TSH联合评估甲状腺功能。展开更多
文摘目的探讨制定合理的新生儿遗传代谢病筛查中心实验室先天性甲状腺功能减低症(congenital hypothyroidism,CH)的筛查切值,减少漏诊率,同时降低假阳性率.方法新生儿于出生72 h后采集足跟血,滴于专用S&S903号滤纸上,在规定的时间内递送到新生儿遗传代谢病筛查中心,采用时间分辨荧光免疫分析方法(Tr-FIA),检测滤纸干血片促甲状腺激素(TSH)浓度.结果 2012至2016年度共检测529 918份新生儿足跟血标本,TSH水平呈正偏态分布,检出正常新生儿数为529645,确诊CH患儿203例,高TSH血症患儿70例,总检出率为1:1941,CH发病率为1:2 610.根据筛查结果,确定实验室时间分辨荧光免疫法筛查CH的TSH参考切值为9.0 m IU/L,其灵敏度达100%,特异度98.38%,漏诊率0%.结论新生儿遗传代谢病筛查中心实验室CH的筛查切值定为9.0 m IU/L,较适合云南省6州/市人群,也为实验室今后的新生儿CH筛查提供了依据.
基金supported by Shanghai Municipal Commission of Health and Family Planning of China(No.20134339)
文摘This study was to explore the optimal threshold of thyroid-stimulating hormone(TSH)-stimulated serum thyroglobulin(s-Tg) for patients who were to receive18F-fluorodeoxyglucose(18F-FDG) PET/CT scan owing to clinical suspicion of differentiated thyroid cancer(DTC) recurrence but negative post-therapeutic 131I whole-body scan(131I-WBS). A total of 60 qualified patients underwent PET/CT scanning from October 2010 to July 2014. The receiver operating characteristic(ROC) curve analyses showed that s-Tg levels over 49 μg/L led to the highest diagnostic accuracy of PET/CT to detect recurrence, with a sensitivity of 89.5% and a specificity of 90.9%. Besides, bivariate correlation analysis showed positive correlation between s-Tg levels and the maximum standardized uptake values(SUVmax) of18F-FDG in patients with positive PET/CT scanning, suggesting a significant influence of TSH both on Tg release and uptake of18F-FDG. So, positive PET/CT imaging is expected when patients have negative 131I-WBS but s-Tg levels over 49 μg/L.
文摘【目的】分析28~36周早产儿生后3~21 d FT3、FT4、TSH变化的特征。【方法】回顾性分析2018年7月至2019年6月中山大学附属第三医院新生儿科住院的236例28~36周早产儿的临床资料,包括甲状腺功能检查(FT3、FT4和TSH)、胎龄、性别、出生体质量、出生身长、检查日龄、辅助生殖方式、单胎或多胎、母亲甲状腺疾病和母亲妊娠期糖尿病,比较早产儿3~7 d与8~21 d FT3、FT4和TSH水平的差异;分析影响早产儿FT3、FT4和TSH水平的独立因素;比较不同胎龄早产儿FT3、FT4和TSH水平差异。【结果】早产儿3~7 d FT3水平(3.23±0.54)pmol/L,低于8~21 d的(3.41±0.76)pmol/L,差异有统计学意义(P=0.040);早产儿3~7 d的FT4水平(15.36±3.40)pmol/L,高于8~21 d的(13.20±2.63)pmol/L,差异有统计学意义(P<0.001);3~7 d与8~21 d的TSH分布的差异没有统计学意义(P=0.846);早产儿3~7 d FT3水平受到胎龄的影响(P<0.001),3~7天FT4水平受到胎龄和检查日龄的影响(P<0.001),8~21 d的FT3、FT4水平均受到胎龄和性别的影响(P<0.001、P<0.001);3~7 d、8~21 d的FT3、FT4水平与胎龄为正相关(P<0.001,P<0.001;P<0.001,P=0.001)。【结论】胎龄影响生后3~21 d早产儿的甲状腺功能,胎龄越小,FT3、FT4越低,需要建立一个胎龄相关的的FT4或T4参考范围,结合TSH联合评估甲状腺功能。
