宁波市先天性甲状腺功能低下症筛查分析  

Neonatal screening for congenital hypothyroidism in Ningbo.

作　　者：钱莹莹[1] 陈意振[1] 张檀[1] 孙玉琴[1] 陈燕玉[1] 

机构地区：[1]宁波市妇女儿童医院,315012

出　　处：《中国优生与遗传杂志》2006年第3期96-97,共2页Chinese Journal of Birth Health & Heredity

摘　　要：目的了解宁波市先天性甲状腺功能低下症（甲低）的筛查率、发病率及探讨其治疗随访的最佳方法，以减少智力障碍的发生。方法1999年1月-2004年9月，采集225787名出生48～72h后的新生儿足跟血滴于特种滤纸血片上，采用时间分辨荧光测定仪测定血斑中促甲状腺素（TSH）浓度；可疑阳性再召回取静脉血，采用化学发光法检测血清中TSH、T3、T4、FT3、FT4水平；对确诊为甲低的患儿，立即予以甲状腺素片或优甲乐片治疗；定期随访监测其生长和生化指标。结果共筛查225787例新生儿，年平均筛查率为96．66％；可疑阳性2073例，确诊158例，年平均发病率为0．70‰；甲状腺素片平均治疗49．6天、优甲乐片平均治疗42．2天后血清中TSH、T4、FT4达到正常范围。结论宁波市甲低的发病率高于各国各地区，可能与地理环境、饮食结构、外省籍人口多等因素有关；选用优甲乐片治疗为宜且随访甚为重要。Objective： Cogenital hypothyroidism （CH） was the most common cause of preventable mental retardation . Neonatal screening for CH was initiated in 1999 to detect newborns with CH and so as to treat the affected infants as early as possible . The aim of the investigation was to achieve the data of CH among children in Ningbo and to get the best way for tracing after certain treatment. Methods： Thyriod -stimulating horone （TSH） screening for CH was done from 1999 to 2004 in neonates of 48 -72 hour age. Three drops of blood were taken from heels of newborms to the filter papers, then the values of TSH were measured by time - resolved fluoro- immunoassay . Infants with elevate TSH level of greater than 10μU/ml were recaUed for tests of serum triiodothyronine （T3）, thyroxine （ T4 ） and TSH by chemilumincsencc. Infants with CH were treated with L - T4 4.54 - 6. 98μg/ （ kg. d） immediately. Growth and development , serum T3, T4, TSH awere followed - up every 3 months for at least 2 years. Results ： 225 787 filter paper samples were tested. The coverage rate was approximately 96.66% of livcbom infants from Ningbo . 158 infants with CH were diagnosed. CH affects about 0. 70‰. They also received routine clinical examination, including assessment of growth and development, laboratory evaluation of thyroid function . After 42.2 days of treatment , the level of serum Ts , T4 and TSH were normalized. Conclusion ： The prevalence of CH of Ningbo is higher than any other areas probably due to variations of geographical environment, as well as dietetic habit. The L - T4 dosage is appropriate for initial treatment of CH. Tracing after certain treatment is also necessary.

关 键 词：先天性甲状腺功能低下症 新生儿疾病筛查 发病率 治疗 随访 

分 类 号：R725.8[医药卫生—儿科]