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目的回顾近年来成都地区新生儿先天性甲状腺功能低下症(congenital hypothyoidism,CH)的筛查情况,分析CH发病率特点及检出情况,为进一步提高新生儿疾病筛查水平提供依据。方法对2008~2014年在成都市妇女儿童中心医院对应的各定点医院所采集的1 210 859例新生儿疾病筛查干滤纸血片标本,采用时间分辨免疫荧光法检测促甲状腺激素浓度进行初筛;结果阳性者召回,静脉采血,用电化学发光法检测并诊断。结果 CH在2008年发病比例为1∶1 869(72/134 594),2014年发病比例为1∶1 280(160/204 810),2008~2014年总发病比例为1∶1 499(808/1 210 859);冷季发病比例(1∶1 209)较暖季发病比例(1∶1973)高(P<0.05),冷季初筛阳性确诊率(7.07%)较暖季初筛阳性确诊率(14.86%)低(P<0.05)。结论本地区CH发病率呈逐步上升趋势,新生儿筛查工作是早期发现和快速诊断CH的有效方法,是新生儿健康的重要保障。
Objective To review the screening status of congenital hypothyroidism (CH) in neonates in Chengdu in recent years, and to analyze the characteristics and detection of CH morbidity, so as to provide basis for further screening of neonatal diseases. Methods A total of 1 210 859 samples of neonatal diseases collected from various fixed-point hospitals in Chengdu Children’s and Children’s Hospital from 2008 to 2014 were collected for screening of dried filter paper. The thyroid-stimulating hormone concentration was detected by time-resolved immunofluorescence for primary screening ; Positive results were recalled venous blood, the use of electrochemiluminescence detection and diagnosis. Results The incidence of CH in 2008 was 1: 1 869 (72/134 594). The incidence of CH in 2014 was 1: 280 (160/204 810). The total incidence of CH in 2008-2014 was 1: 1 499 (808 / 1 210 859). The incidence of cold season (1: 1 209) was higher than that of warm season (1:1973) (P <0.05). The positive rate of positive screening in cold season was 7.07% The rate (14.86%) was low (P <0.05). Conclusions The incidence of CH in this area shows a gradual upward trend. Neonatal screening is an effective method for early detection and rapid diagnosis of CH, which is an important guarantee for neonatal health.