目的　初步探讨联合检测干血滤纸片中促甲状腺素(TSH) 及游离甲状腺素(FT4) 水平筛查新生儿先天性甲状腺功能减低症(CH) 的临床意义。方法　对2013 年6 月至2013 年12 月出生的活产新生儿，采用时间分辨荧光免疫分析法联合检测干血滤纸片中TSH 及FT4 水平；对筛查阳性者再采血检测血清TSH 及FT4 水平，并与干血滤纸片法结果进行比较。结果 共筛查新生儿31 199 例，确诊CH 12 例，发生率1/2 600，高TSH 血症4 例，未检测到垂体性甲状腺功能减低症。筛查确诊CH新生儿的血清TSH及FT4 的检测结果与干血滤纸片检测结果一致，差异无统计学意义(P>0.05)。结论　联合检测干血滤纸片中TSH 及FT4 水平可用于新生儿CH 筛查，并有助于早期诊断与治疗，以及对中枢性CH的筛查。

Objective To explore the clinical significance of combined detection of thyroid stimulating hormone (TSH) and free thyroxin (FT4) in dried blood spots in screening for congenital hypothyroidism (CH) in neonates. Methods The TSH and FT4 levels in dried blood spot were measured by time-resolved fluorescence immunity in live born neonates from June to December 2013. If the screening was positive, the blood was drawn and the serum TSH and FT4 were measured and compared with the results from dried blood spots. Results In a total of 31 199 neonates screened, 12 cases were diagnosed with CH and the prevalence rate of CH was 1/2 600; 4 cases were hyperthyropinemia and no pituitary CH was detected. There was no significant difference between TSH or FT4 levels in dried blood spot and those in serum in neonates diagnosed with CH (P>0.05). Conclusions Combined detection of TSH and FT4 in dried blood spot can be used for neonatal screening of CH. It can be applied for early distinguishing CH from hyperthyropinemia, and also helpful for early diagnosis and treatment of central CH.