2008-2013年陕西省宝鸡市先天性新生儿甲状腺功能减低症筛查结果分析  

Analysis of screening results of congenital hypothyroidism in neonates in Baoji City of Shaanxi Province in 2008-2013

作　　者：朱宏伟[1] 李和勤[2] 刘郁明[3] 高艳琴[1] 刘梅[1] 王伟华[4] 杨海峰[1] 武永平[1] 

机构地区：[1]陕西省宝鸡市疾病预防控制中心地方病防治科,721006 [2]宝鸡市妇幼保健院新生儿科 [3]宝鸡市妇幼保健院遗传实验室 [4]宝鸡市妇幼保健院医疗教育科

出　　处：《中华地方病学杂志》2015年第3期217-220,共4页Chinese Journal of Endemiology

摘　　要：目的 了解宝鸡市碘缺乏病防治效果,为碘缺乏病决策和调整干预措施提供必要的信息.方法 收集2008年11月至2013年10月在宝鸡市妇幼保健院筛查的先天性新生儿甲状腺功能减低症（CH）的基本资料,包括促甲状腺激素（TSH）、总三碘甲状腺原氨酸（TT3）、游离三碘甲状腺原氨酸wT3）、总甲状腺素（TT4）、游离甲状腺素（FT4）等,并进行描述性分析.另外,于2013年,在宝鸡市所辖的12个县区,每个县区按东、西、南、北、中划分为5个片区,在每个片区各抽取12名孕妇,收集其一次性尿样5ml;在宝鸡市的东、西、南、北、中5个方位,各抽取3名已确诊为新生儿CH患儿的生母（在其生产1年后）,收集其一次性尿样5ml,采用砷铈催化分光光度测定法（WS/T 107-2006）检测尿碘.结果 2008-2013年,宝鸡市共筛查新生儿198 575例,其中确诊新生儿CH 68例,检出率为0.34‰;TSH＞ 5.0 mU/L的有9 937人,检出率为5.00％;TSH≥8.5 mU/L的有94例.共检测720名孕妇尿样,尿碘中位数为218.57μg/L,尿碘＜150.00 μg/L的有222人,占30.83％（222/720）;共检测15名CH患儿生母尿样,尿碘中位数为362.80 μg/L.结论 宝鸡市孕妇碘营养状况良好,新生儿CH发病的检出率低于全国平均水平（0.49‰）.今后的工作中应加强妊娠妇女的尿碘监测,尽可能消除碘缺乏对新生儿的影响.Objective To understand the control effect of iodine deficiency disorders （IDD） in Baoji City,and to provide necessary information for decision-making and adjustment of IDD intervention.Methods From November 2008 to October 2013,basic information of congenital hypothyroidism （CH） was collected in Child Health Hospital of Baoji City,including thyroid stimulating hormone （TSH）,three total triiodothyronine （TT3）,free triiodothyronine （FT3）,total thyroxine （TT4）,free thyroxine （FT4）,and descriptive analysis was conducted.In 2013,12 counties of Baoji City were selected; each county was divided into east,west,south,north and center parts; 12 pregnant women were selected in each part,and a disposable urine sample （5 ml） was collected; in the east,west,south,north and center parts of Baoji City,3 mothers whose children had been diagnosed neonatal CH （1 years after giving birth） were selected,and a disposable urine sample （5 ml） was collected.Urinary iodine was detected by arsenic cerium catalytic spectrophotometry （WS/T 107-2006）.Results In 2008-2013,a total of 198 575 cases of neonatal were screened,of which 68 cases were diagnosed as neonatal CH,the detection rate was 0.34 per thousand; TSH ＞ 5.0 mU/L was 9 937,the detection rate was 5.00％; TSH ≥ 8.5 mU/L was 94.A total of 720 pregnant women were examined,the median of urinary iodine was 218.57 μg/L,＜ 150.00 μg/L was 222 people,accounted for 30.83％ （222/720）.A total of postpartum mothers were examined,the median of urinary iodine was 362.80 μg/L,there was no significant difference between pregnant women with postpartum mothers （P ＞ 0.05）.Conclusions In Baoji City,iodine nutritional status of pregnant women is good,and the detection rate of CH is lower than the national average level （0.49‰）.The monitoring of urinary iodine of pregnant women should be strengthened in the future to eliminate the influence of iodine deficiency on neonates.

关 键 词：尿 碘 发病率 数据收集 

分 类 号：R722.1[医药卫生—儿科]