温州市新生儿先天性甲状腺功能减低症的筛查结果分析

Screening results analysis of congenital hypothyroidism in neonates in Wenzhou City

目的回顾分析温州医科大学附属第二医院2015年-2017年新生儿先天性甲状腺功能减低症(CH)的筛查结果及确诊情况,了解新生儿CH的发病率及CH患儿的初始治疗时间。方法 2015年-2017年本院出生的31 553例新生儿,于出生72 h后采集足部末梢血,采用时间分辨荧光免疫法检测血斑中促甲状腺激素(TSH),筛查结果阳性者召回抽取静脉血测定血清TSH、游离T4以确诊。结果 2015年-2017年本院共筛查新生儿CH 31 553例,筛查阳性为93例,筛查阳性率为0. 29%(93/31 553);召回复查93例,召回率为100. 00%(93/93),确诊CH 32例,发病率为1/986(32/31 553);CH筛查阳性率冬季与春季、夏季、秋季比较,差异均有统计学意义(P <0. 01);患儿在出生30 d内初始治疗占78. 13%(25/32)。结论 2015年-2017年于本院出生的31 553例新生儿中CH发病率较高,高于全国及浙江省的平均发病率,冬季筛查阳性率高于其他3季,确诊为CH的患儿初始治疗时间较理想。

Objective To analyze the screening and diagnosis results of congenital hypothyroidism(CH)in neonates born in the Second Affiliated Hospital of Wenzhou Medical University during 2015-2017 to understand the incidence and initial treatment time for CH in neonates.Methods All the neonates born in our hospital from 2015 to 2017 were collected from the peripheral blood at 72 h after birth.Time-resolved fluorescence immunoassay was used to detect thyroid stimulating hormone(TSH)in blood spots.The patients with positive screening results were recalled to take venous blood to determine serum TSH and free T4 for diagnosis.Results A total of 31553 neonates were screened for CH from 2015 to 2017,of which 93 positive cases were called back for diagnosis test,the positive rate of screening was 0.29%(93/31553)and 32 cases of CH were diagnosed with a incidence rate of 1/986(32/31553).And the positive rate of CH screening in winter was different from that in spring,in summer and in autumn,and the differences were statistically significant(P<0.01).The proportion of initial treatment within 30 days after birth was 78.13%(25/32).Conclusion The incidence rate of CH in 31553 newborns of the Second Affiliated Hospital of Wenzhou Medical University was higher than that of the national and Zhejiang Province during2015-2017.The positive rate of screening in winter was higher than that in the other three seasons.The initial treatment time of the neonates diagnosed with CH is ideal.