广东湛江地区先天性甲状腺功能减低症筛查报告

Screening of newborns for congenital hypothyroidism(CH)in Zhanjiang,Guangdong Province.

本文报告了 1997年 8月 - 2 0 0 0年 3月在湛江市四区及所属 5县 (市 ) 36家医疗保健单位出生的 2 80 0 0名新生儿先天性甲状腺功能低下症筛查的结果。用滤纸干血斑法检测 (EIA)TSH为初筛指标。对初筛结果两次均 >10mUI/L者 ,复检血清TSH及T4、T3。X线膝关节摄片确定骨龄 ,彩超扫描甲状腺 ,同时全面体检了解患儿发育 ,调查其妊娠、分娩及家庭状况。筛查出先甲低患儿 10例 ,先甲低发病率为 1/ 2 80 0 ,明显高于全国平均水平 1/ 5 0 0 0及广州市水平 1/ 475 0。 10例先甲低患儿未发现 1例甲状腺的异位或缺如 ,与国内外新生儿筛查报告的先甲低有所不同 ,结果表明属于散发性甲低。发病与缺碘无明显关系 ,可能与孕妇年龄及妊娠异常有关。

Objectve:This article shows the results of 28000 newborns with congenital hypothyroidism(CH)who were born in 36 hospitals respectively in Zhanjiang area,including 4 distracts and 5 counties.We used enzyme immunoassay(EIA) to determine the infant thyrotrophins from their blood specimens dred on filter paper for CH screening.If his(or her)thyroid stmulating hormone(hTSH)levels>10mUI/L twice,we would call him(or her )back to measure his(or her )serum levels of TSH.T 3 and T 4,to take X-ray photographs of his (or her )knee joints for determination of marrow age,to scan the thyroid gland with colored supersonic instrument,and to check all the other physical statuses in order to know how the infant developed .Also we investigated the process of pregnancy and parturition as well as his(or her )family.Among them 1/2,800(10 cases)was found to be CH,which was much higher than the average level of the whole country(1/5,000)and that of Guangzhou(1/4,750).From these 10 cases,no aberrant thyroid or thyroprivia had been discovered,different from other reports on neonatal CH screening.Our results suggest that these 10 cases may be sporadic and have no apparent relation with iodine deificency but seem to be related to abnormal pregnancy and the age of woman.