17-OHP 和 ACTH 联合检测在新生儿先天性肾上腺皮质 增生症早期诊断中的应用研究.

Objective To evaluate the application value of the serum 17-hydroxyprogesterone (17OHP) and adrenocorticotropic hormone (ACTH) combined detection in the early diagnosis of congenital adrenocortical 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 indicators such as progesterone (PROG II), 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 PROGII, 17-OHP, ACTH and TESTO were statistically significant between the two groups (P<0.001); the multi-factor logistic regression analysis showed that PROGII, 17-OHP and ACTH were the independent influencing factors of neonates suffering from CAH (P<0.05). The receiver operating characteristic (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 PROG III, 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 CAН. [ABSTRACT FROM AUTHOR]

目的 评价血清17-羟孕酮 (17-OHP) 和促肾上腺皮质激素 (ACTH) 两种指标联合检测在新生 儿先天性肾上腺皮质增生症 (CAH) 早期诊断中的应用价值。方法 选取 2019 年 1 月至 2022 年 6 月该院收治 的 CAH 38 例作为观察组, 同期单纯新生儿高胆红素血症 38 例作为对照组。收集临床资料, 并对临床常用血 清指标孕酮 (PROGⅢ)、17-OHP、ACTH、睾酮 (TESTO) 单指标和两项指标联合检测对新生儿 CAH 的早期诊 断效能进行分析。结果 血清 PROGⅢ、17-OHP、ACTH、TESTO 的水平在两组间比较, 差异均有统计学意义 (P<0. 001); 多因素 logistic 回归分析显示 PROGⅢ、17-OHP、ACTH 是新生儿 CAH 患病的独立影响因素 (P<0. 05)。单指标和两项指标联合检测的受试者工作特征曲线 (ROC曲线) 分析表明 17-OHP+ACTH 联合 检测的曲 线 下 面 积 (AUC) 最 高 为 0.954 (95%CI 0. 906~1. 000), 灵 敏 度 为 89. 5%, 特 异 度 为 94. 7%。 结论 CAH 患儿 PROGⅢ、17-OHP、ACTH、TESTO 水平显著增高, 17-OHP 和 ACTH 两项指标联合检测对 新生儿 CAH 有较高的早期诊断效能。 [ABSTRACT FROM AUTHOR]