新生儿甲状腺功能二次筛查的价值  

Effect of Secondary Screening of Neonatal Thyroid Function

作　　者：郭传超 骆健 王源 GUO Chuanchao;LUO Jian;WANG Yuan(Department of Pediatric,Xiamen Changgeng Hospital,Xiamen 361000,China)

机构地区：[1]厦门长庚医院儿科,福建厦门361000

出　　处：《中国医药指南》2021年第33期89-91,共3页Guide of China Medicine

摘　　要：目的对首次甲状腺功能筛查可能出现假阴性的新生儿进行二次筛查,尽可能最大限度的早期发现新生儿甲状腺功能异常。方法选取2015年1月至2018年12月在厦门长庚医院出生,出生3 d充分喂养后、早产儿奶量达到足量时采足跟血进行甲状腺功能筛查的26187例新生儿,对其中可能出现假阴性的2506例新生儿,在生后14~35 d进行二次筛查,对二次筛查的结果进行回顾性分析。结果新生儿首次筛查甲状腺功能阴性,二次筛查时的阳性率为0.18%(46/26187),占可能出现假阴性的1.84%(46/2506)。其中新生儿甲状腺功能低下、高促甲状腺激素血症分别占17.39%、67.40%,低游离甲状腺素血症(简称低T4血症)和中枢性甲状腺功能减退分别占8.70%和4.35%,甲状腺功能亢进占2.17%。结论母亲妊娠期间甲状腺功能异常、出生时胎龄在28~31周的早产儿、脏器畸形、发育缺陷的数量≥3个的新生儿,在首次新生儿甲状腺功能筛查时可能出现假阴性,需在生后14~35 d后择机行二次筛查,以减少新生儿甲状腺功能异常的发生。Objective To study and analyze the newborns who may have false negative in the first thyroid function screening,so as to find the neonatal thyroid dysfunction as early as possible.Methods A total of 26187 newborns born in Xiamen Changgeng Hospital from January 2015 to December,2018,who were fully fed three days after birth and took heel blood for thyroid function screening when the milk volume of preterm infants reached sufficient volume,were selected.Two thousand five hundred and six newborns who may have false negative were screened again 14 to 35 days after birth,and the results of the second screening were analyzed retrospectively.Results The thyroid function of newborns was negative in the first screening,and the positive rate in the second screening was 0.18%(46/26187),accounting for 1.84%(46/2506).Neonatal hypothyroidism and hyperthyroidism accounted for 17.39%and 67.40%respectively,hypothyroidism and central hypothyroidism accounted for 8.70%and 4.35%respectively,and hyperthyroidism accounted for 2.17%.Conclusion The newborns with abnormal thyroid function during pregnancy,premature infants with gestational age of 28~31 weeks at birth,organ malformations and developmental defects≥3 may have false negative during the first neonatal thyroid function screening.The second screening should be carried out 14~35 d after birth to reduce the incidence of neonatal thyroid dysfunction.

关 键 词：妊娠期 甲状腺功能异常 胎龄 脏器畸形 二次筛查 

分 类 号：R714.25[医药卫生—妇产科学]