黄山市2012~2016年先天性甲状腺功能减低症的筛查与治疗

Screening and Treatment of congenital hypothyroidism in Huangshan City from 2012 to 2016

[目的]探讨黄山市2012~2016年先天性甲状腺功能减低症(CH)的筛查与治疗.[方法]选取2012年1月至2016年12月在黄山市各医疗机构活产分娩并接受新生儿促甲状腺素(TSH)筛查增高者,重新静脉采血检测甲状腺功能,确诊者口服小剂量左甲状腺素钠片治疗.随访2~3年,观察暂时性CH和持续性CH的发生率.[结果]2012~2016年,黄山市活产新生儿共62276例,CH筛查60945例,筛查率97.86%,筛查阳性59例,阳性率0.968‰.2014年CH筛查阳性阳性率最高(1.15‰),2016年最低(0.725‰).共57例获得随访,其中CH 36例,发病率为0.591‰,男17例,女18例,男女比例为1:1.06,高TSH血症21例,发病率为0.345‰.36例CH患儿治疗2~3年后,确诊持续性CH19例(52.78%),确诊暂时性CH 17例(47.22%).[结论]黄山市是新生儿CH高发地区,2012~2016年CH发病率高,新生儿CH筛查可及早确诊CH.黄山市暂时性CH发生率高,需要加强孕期宣教、调整饮食结构等措施,降低本地区新生儿CH发病率.

[Objective]To investigate the screening and treatment of congenital hypothyroidism(CH)in Huangshan City from 2012 to 2016.[Methods]The live births who received neonatal thyroid stimulating hormone(TSH)screening from the medical institutions in Huangshan City between January 2012 to December 2016 were selected for the study.Venous blood was re cllctede for those with high level of TSH to test thyroid function and confirm the diagnosis of congenital hypothyroidism.The CH confirmed children were given low dose levothyroxine sodium tablets.After 2-3 years of follow-up,the incidence of transient CH and persistent CH was observed,[Results]From 2012 to 2016,there were 62276 live births in Huangshan City.Among those.60945 cases received the CH screening.The screening rate was 97.86%.There were 59 positive CH cases showing the postive rate 0.968%.In 2014,the positive rate of CH screening was the highest(1.15%)and the lowest rate was 0.725%。in 2016.A total of 57 CH screening positive cases were followed up and showed 36 CH patients,whose incidence rate was 0.591%o including 17 males and 18 females(the ratio of male to female was1:1.06).There were 21 cases of hyper-TSHemia with an incidence rate of 0.345%s.After 2-3 years of treatment,19 out of the 36 CH patients were persistent(52.78%)and 17 patients were temporary(47.22%)CH.[Conclusion]Huang-shan City shows a high-incidence area of neonatal CH from 2012 to 2016.CH can be diagnosed early by nconatal CH screening,The incidence of temporary CH in Huangshan City is also high.It is necessary to strengthen the education during pregnancy and adjust the diet structure to reduce the infidence of CH in newborns in this area.