斯洛伐克共和国扩大新生儿筛查的初步结果

S. Dluholucký, M. Knapkova, M. Zahorcova
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引用次数: 5

摘要

一年半的经验,扩大新生儿筛查(ENBS)在斯洛伐克提供的手段串联质谱(LC-MS/MS)提出。方法从SK国家筛查中心的常规NBS干血样本中实现ENBS。所使用的LC-MS/MS软件允许在MRM模式下对73种分析物进行每日值99%的下限切割后的评估。常规ENBS面向10种遗传代谢紊乱(IMDs)、有机酸和肉毒碱缺陷(PKU/HPA、MSUD、GAI、IVA、MCAD、LCHAD、SCAD、CPT I、CPT II、CACT)。除此之外,在方法的周长范围内还记录了许多其他结果的变化。他们被单独评估,直到确认或排除疑似诊断。结果在1年半的时间里,共有82 892名新生儿接受ENBS检查,发现并确诊IMDs阳性病例34例,筛查率为1:2438。其中,24例来自常规ENBS (PKU/HPA, MSUD, MCAD),发病率为1:3 454,LC-MS/MS评估外周另有10例,患病率为1:8 286。结论初步经验和结果表明,该方法不仅对常规ENBS中包含的10个imd具有较高的检测效率,而且在LC-MS/MS方法的周长范围内也具有较高的检测效率,可以检测出常规ENBS谱中未包含的其他imd。这一群体占所有病例的29%。一般来说,患病率与PKU和/或CAH相当。
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First Results From Expanded Newborn Screening in slovak Republic
Abstract A one-and-a-half year experience with expanded newborn screening (ENBS) in Slovakia provided by means of tandem mass spectrometry (LC-MS/MS) is presented. Method ENBS was realised from dry blood samples of the regular NBS in National Screening Centre SK. The LC-MS/MS software used allowed evaluating even 73 analytes in MRM mode after cut-of limits in 99 percentile of daily values. The regular ENBS was oriented to 10 inherited metabolic disorders (IMDs), organic acids and carnitine defects (PKU/HPA, MSUD, GAI, IVA, MCAD, LCHAD, SCAD, CPT I, CPT II, CACT). Except these, many other variations of results were registered in perimeter of the method. They were individually evaluated until the confrmation or exclusion of the suspected diagnosis. Results During the one-and-a-half years, 82 892 newborns were evaluated by ENBS and 34 positive cases of IMDs were detected and confrmed, which represents a screening prevalence of 1:2438 newborns. Out of these, 24 cases were from regular ENBS (PKU/HPA, MSUD, MCAD) with an incidence of 1:3 454, and 10 additional cases at the periphery of LC-MS/MS evaluation with a prevalence of 1:8 286. Conclusion Preliminary experience and results with ENBS confrmed its high efectiveness not only in 10 IMDs included in regular ENBS, but also at perimeter of LC-MS/MS method, in which it is possible to detect additional IMDs not included in regular spectrum of ENBS. This group comprised 29% of all cases. In general, the prevalence is comparable with PKU and/or CAH.
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