三亚市新生儿先天性甲状腺功能低下发病率及影响因素分析

Analysis on the incidence of newborn congenital hypothyroidism and its influencing factors in Sanya city

目的了解三亚市新生儿先天性甲状腺功能低下(congenital hypothyroidism,CH)发病率及其影响因素,从而为有针对性地进行早期防治提供理论依据。方法选取2017年01~06月在三亚市妇幼保健院出生的新生儿5179例,并在72h后均予采集足跟内、外侧血,且在规定时间内送达海南医学院遗传代谢筛查中心进行筛检。对筛检阳性者使用化学发光法检测血清中的T4、FT4、T3、FT3及TSH,同时采用彩超检查甲状腺发育情况,随后采集确诊儿母亲和正常产妇资料。结果三亚地区5179例新生儿中CH筛查阳性27例,进一步确诊为CH者4例,其发病率约0.77‰。Logistic回归分析结果显示:孕母的甲状腺功能低下、甲状腺功能亢进、亚临床甲状腺功能减退、文化程度、初产、饮食习惯等是导致新生儿CH发生的独立高危因素(P<0.01或0.05)。结论三亚市新生儿CH发病率相对较高,并且影响因素颇多。其中,加强母孕期甲状腺功能异常管理与治疗、提高孕妇对CH认知度以及科学合理膳食是预防CH患儿出生的有效方法。

Objective：To study the incidence of newborn congenital hypothyroidism and its influencing factors in Sanya city so that it provides theoretical basis for early prevention and control newborn congenital hypothyroidism.Methods：Selected a total of 5179 newborns were born in Maternity and Child Health Care Hospital of Sanya from January 2017 to June 2017,who′s the blood was collected from the heel after 72 h.And it was delivered to the genetic metabolic screening center of hainan medical college for screening.The T4,FT4,T3,FT3 and TSH in the positive patients serum were detected by chemiluminescence detection.At the same time,the development of thyroid gland by color ultrasonography examining.The child was diagnosed with his or her mother＇s and normal maternal＇s information were collected.Results：Among the 5179 newborn cases in sanya,who 27 ones were tested positive for CH.However,finally confirmed cases were 4 cases of CH.So its incidence is about 0.77‰.Logistic regression analysis showed that the hypothyroidism,hyperthyroidism and subclinical hypothyroidism of progestational mother,educational level,primiparity,dietary habit and so on for the independent high risk factors that causes neonatal CH to occur（P〈0.01 or 0.05）.Conclusion：The incidence of neonatal CH in sanya is relatively high and there are many influential factors.So it is effective to strengthen the management and treatment of thyroid function abnormality during pregnancy and improve pregnant women′s understanding of CH recognition and scientific and reasonable diet.