广州地区2009～2012年新生儿先天性甲状腺功能减低症筛查结果分析  

Analysis on the screening results of neonatal congenital hypothyroidism in Guangzhou from 2009 to 2012

作　　者：李蓓 贾雪芳 陈倩瑜 蒋翔 吴伽 曹伟锋 江剑辉 

机构地区：[1]广东省广州市妇女儿童医疗中心 广州市新生儿疾病筛查中心,510180

出　　处：《中国妇幼保健》2015年第8期1242-1244,共3页Maternal and Child Health Care of China

摘　　要：目的：分析广州市2009~2012年新生儿先天性甲状腺功能减低症（CH）筛查、召回和确诊结果,了解广州地区CH筛查情况,为进一步做好筛查工作提供依据。方法：利用荧光酶免疫方法对2009~2012年广州市出生的新生儿进行足底血片促甲状腺素（TSH）筛查,诊断筛查结果阳性者及时召回,测定TSH、游离T3（FT3）、游离T4（FT4）复查确诊。结果：2009~2012年新生儿CH筛查人数分别为156 706例、156 444例、193 127例、211 345例。CH确诊人数分别为74例、91例、93例、103例。CH发病率分别为47.22/10万、58.17/10万、48.15/10万、48.74/10万,经χ2趋势检验,差异无统计学意义。四年间CH阳性召回率分别为98.39%、99.01%、98.12%、98.08%,有69例阳性标本失召。结论：新生儿疾病筛查是CH早期诊断的有效措施,建立有效的筛查召回网络,加强宣传教育工作,提高患者家属认识以及强化医务工作人员培训能有效提高筛查率和召回率,降低CH患儿残疾发病率,提高出生人口素质。Objective： To analyze the screening,recall and definite diagnosis results of neonatal congenital hypothyroidism（ CH）in Guangzhou from 2009 to 2012,understand CH screening situation in Guangzhou,provide a basis for further accomplishing CH screening.Methods： FEIA was used to detect thyroid stimulating hormone（ TSH） concentration in dried blood spot specimens of the neonates born in Guangzhou from 2009 to 2012,the positive neonates were recalled for definite diagnosis,TSH,free triiodothyronine and free thyroxine concentrations were reexamined. Results： From 2009 to 2012,156 706 neonates,156 444 neonates,193 127 neonates and 211 345 neonates received CH screening,respectively; 74 neonates,91 neonates,93 neonates and 103 neonates were diagnosed as CH definitely,respectively; the morbidities of CH were 47. 22 /100 000,58. 17 /100 000,48. 15 /100 000 and 48. 74 /100 000,respectively,there was no statistically significant difference in morbidity of CH. The recall rates of positive neonates were 98. 39%,99. 01%,98. 12% and 98. 08%,respectively; 69 positive neonates were missed eventually. Conclusion： Neonatal screening is an effective measure for early diagnosis of CH. Establishing effective recall network,enhancing publicity and education,improving cognition of the family members to CH and strengthening training for the medical staff will effectively increase screening rate and recall rate,reduce the morbidities of disabilities among CH neonates and improve the quality of birth population.

关 键 词：先天性甲状腺功能减低症 促甲状腺素 新生儿筛查 

分 类 号：R581.2[医药卫生—内分泌]