2000—2009年连云港市新生儿先天性甲状腺功能低下症筛查分析

Analysis of screening for congenital hypothyroidism on neonates in Lianyungang City,2000—2009

目的分析连云港市新生儿先天性甲状腺功能低下症(CH)发病率及碘营养状况对CH发病率的影响。方法筛查对象为连云港市142家有助产资质的医院足月顺产新生儿共431 524名。按卫生部《新生儿疾病筛查技术规范》进行。结果该市2000年实施新生儿筛查,从431 524名新生儿中确诊212名CH(发病率1/2035),其中2007、2008年CH发病率有明显增长(1/1 385,1/1 435)。2009年CH发病率(1/2 602)恢复到2006年水平(1/2 732)。分析CH发病率上升的因素,可能是人群碘营养过量有关(1998年尿碘MUI≥300μg/L),经调整IDD防治策略,2009年儿童尿碘MUI 127.0μg/L,母亲尿碘MUI 261.1μg/L结论对于基础是碘缺乏的人群,高碘摄入会引起甲状腺疾病的增加,否定食盐碘化(USI)政策是不可取的,然而盲目补碘也是错误的。

Objective To investigate the incidence of newborns with congenital hypothyroidism（CH） in Lianyungang City during last ten years and evaluate the effect of iodine nutritional condition on that. Methods A total of 431 524 neonates were screened according to the technical criterions established by the Ministry of Health. Results The neonatal screening for CH was carried out since 2000,and 212 neonates were diagnosed as CH from 431 524（the incidence was 1/2 035）.The incidence increased in 2007（1/1 385） and 2008（1/1 435）.The incidence in 2009（1/2 602） came back to the level of 2006（1/2 732）.The increase of CH might be related to the excessive iodine intake. Conclusions In a crowd with absence iodine,excessive iodine intake may increase the hypothyroid disease;therefore,iodine intake should be suitable.