广西地区单双胎因素与新生儿先天性甲状腺功能异常的相关性研究

Study on the correlation between single birth or twin and neonatal congenital hypothyroidism in Guangxi

目的：分析2009-2014年5月广西地区新生儿先天性甲状腺功能减低症（CH）筛查中单胎与双胎的筛查情况,探讨单双胎因素与新生儿先天性甲状腺功能异常的相关性。方法：选取2009-2014年5月广西地区1047483例新生儿（其中单胎1034213例,双胎6635对）的干血片标本,采用时间分辨荧光法检测促甲状腺素（TSH）水平,采用化学发光法检测患儿血清中的游离T3（FT3）、游离T4（FT4）以及TSH水平,同时进行甲状腺显影扫描。结果：双胎CH发病率为1/1056,单胎CH发病率为1/1 968,单双胎发病率比较,差异有统计学意义（P〈0.05）。结论：新生儿双胎CH发病率远高于单胎。在双胎新生儿CH筛查中若有一方确诊,同胞的另一方最好作为可疑阳性召回复查,防止漏诊。

Objective： To analyze the screening result of single birth and twin during neonatal congenital hypothyroidism （CH） screening in Guangxi from 2009 to May 2014, explore the correlation between single birth or twin and neonatal CH. Methods： The dried blood spots specimens of 1 047 483 neonates （1 034 213 cases of single birth and 6 635 twin pairs） were selected from Guangxi from 2009 to May 2014, time resolved fluorimetric determination was used to detect the levels of thyroid stimulating hormone （ TSH）, chemiluminescence method was used to detect the levels of serum free triiodothyronine （ FT3 ）, free thyroxine （ FT4 ）, and TSH ; thyroid scanning was performed. Results： The prevalence rates of CH of twin and single birth were 1/1 056 and 1/1 968, respectively, there was statistically significant difference （P〈0. 05） . Conclusion： The prevalence rate of CH of twin is significantly higher than that of single birth. If one of the twin is diagnosed as CH definitely, the other should be recalled as suspected positive case in order to prevent missed diagnosis.