云南省部分地区新生儿先天性甲状腺功能减低症筛查结果分析  

Analysis of neonatal screening results for congenital hypothyroidism in parts of Yunnan Province, China

作　　者：章印红[1,2] 李利[3,2] 陈红[1,2] 朱姝[1,2] 张杰[1,2] 李苏云[1,2] 王瑞红[1,2] 朱宝生[1,2] 

机构地区：[1]云南省第一人民医院遗传诊断中心,云南昆明650032 [2]云南省出生缺陷与遗传病研究重点实验室,云南昆明650032 [3]云南省第一人民医院儿科,云南昆明650032

出　　处：《中国当代儿科杂志》2015年第1期45-48,共4页Chinese Journal of Contemporary Pediatrics

基　　金：云南省自然科学基金项目(2009ZC170M);云南省卫生科技计划项目(2009NS001);云南省卫生科技计划项目(2011WS0004)

摘　　要：目的：总结并分析云南省部分州市先天性甲状腺功能减低症（CH）的筛查结果。方法对2012年7月至2014年4月在云南省昭通市、曲靖市、丽江市和迪庆藏族自治州四地出生的活产婴儿236218例进行CH筛查，其中男121463例，女114755例。初筛足跟血促甲状腺激素（TSH）≥8μIU/L者原血片重新复查，复查后仍为阳性者召回进一步测定静脉血TSH和游离甲状腺素（FT4）以明确诊断。结果236218名新生儿中，血片合格率为96.67%，不合格血片补采率为81.75%，初筛阳性召回率为73.02%。确诊CH 66例，其中男性36例，女性30例（P〉0.05）。CH发病率为1：3579，显著低于全国平均发病水平（1/2034，P〈0.01）。患儿出生胎龄多为37-42周，〉42周者只占3%；大部分患儿出生体重在正常范围；出生身长〈50 cm者占32%。结论云南地区CH发病率低于全国平均水平；CH患儿临床特征无特异性；云南地区新生儿疾病筛查工作质量还需要进一步提高。Objective To summarize and analyze neonatal screening results for congenital hypothyroidism （CH） in parts of Yunnan Province, China. Methods A total of 236 218 newborns （121 463 males and 114 755 females） who were born in Zhaotong City, Qujing City, Lijiang City, and Diqing Tibetan Autonomous Prefecture of Yunnan Province, China, between July 2012 and April 2014 were screened for CH. The original blood smear was re-tested if the thyroid stimulating hormone （TSH） level in heel blood was ≥8 μIU/L in the initial screening. The newborns with positive TSH results were called back for further diagnosis by measuring blood TSH and free thyroxine （FT4） levels. Results Among 236 218 newborns, the pass rate of blood smears, re-acquisition rate of unqualiifed blood smears, and recall rate of suspected cases were 96.67%, 81.75%, and 73.02%, respectively. Sixty-six cases of CH were conifrmed, among which 36 were male infants and 30 were female infants （P〉0.05）. The incidence rate of CH was 1/3 579, which was signiifcantly lower than the national average rate （1/2 034;P〈0.01）. The gestational age of CH newborns was mostly between 37 to 42 weeks, and only 3% were born at a gestational age of 〉42 weeks. Most of the CH newborns had normal birth weight. The CH newborns with a body length of〈50 cm accounted for 32%. Conclusions The incidence of CH in Yunnan Province is lower than the national average. There are no speciifc clinical features in CH newborns. The neonatal screening in Yunnan Province needs further improvement.

关 键 词：先天性甲状腺功能减低症 新生儿筛查 促甲状腺激素 新生儿 

分 类 号：R722.1[医药卫生—儿科]