多胎新生儿先天性甲状腺功能减低症筛查结果分析及召回方式的探讨

Analysis of multi-pregnancies results on congenital hypothyroidism neonatal screening and suggestion about recall-back mode

目的探讨多胎因素对新生儿先天性甲状腺功能减低症筛查结果的影响,并采取相应的对策。方法用免疫酶荧光法测定广州市新生儿干血片TSH值,筛查阳性患儿及时召回测定TSH、FT3、FT4作出诊断。对确诊为CH的患儿分别按照单胎多胎因素进行分组统计分析。结果 2011-2012年共筛查新生儿424 472例,确诊CH 194例,CH发病率为1/2 188。其中单胎新生儿CH发病率为1/2 237,多胎新生儿CH发病率为1/652,单胎和多胎新生儿的CH发病率差异有统计学意义(P<0.05)。结论新生儿多胎CH发病率要高于单胎CH发病率。在新生儿筛查工作中,对于双胎或多胎的阳性标本,建议若筛查出1例阳性,其余均作为可疑阳性召回以防止漏诊。

Objective To study the relationship of congenital hypothyroidism screening results with muhi-pregnancies in newborn infants. Methods Detection of thyroid stimulating hormone （TSH） concentration from blood specimens dried on fliter paper by Fluorescence Enzyme Immunoassay （FEIA）. The neonates were divided into two groups according to multi-pregnancies,and the correlation was analysed between prevalence of CH and different pregnancies. Results A total of 424 472 infants were screened,and 194 cases were identified with CH. The prevalence rate was 1/2 188. The prevalence of singletons,multi-pregnancies were 1/2 237,1/652 respectively. The prevalence of CH was significantly different between singletons groups and multi-pregnancy groups. Conclusions The prevalence of CH is associated with multi-pregnancies. In case of missed diagonosis of CH,it is strongly recommendable to recall them back if one of each multi-pregnancies results was positive.