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目的调查分析宁波地区2011年~2014年新生儿先天性甲状腺功能减低症(congenital hypothyroidism,简称CH)的筛查和确诊情况,了解本地区该病的筛查情况,为今后进一步做好筛查工作提供有效依据。方法利用时间分辨免疫荧光分析(DELFIA)对2011年~2014年宁波市出生的新生儿进行足底血片筛查,诊断筛查结果阳性者通过测定TSH、游离T3(FT3)、游离T4(FT4)复查进行确诊。结果 2011年~2014年宁波地区CH筛查人数分别为89 619例,95 313例,89 469例,87 312例,CH确诊人数分别为61例,86例,58例,68例。CH发病率分别为68.07/10万,90.23/10万,64.83/10万,77.88/10万,经χ2趋势检验,历年发病率差异无统计学意义。4年间CH阳性人数召回率分别为97.24%,98.82%,98.38%,98.63%,有109例阳性标本失召。结论宁波地区CH发病率高,而新生儿疾病筛查是CH早期诊断的有效措施,建立有效的筛查、召回及随访系统,降低CH患儿病残率,从而提高出生人口素质。
Objective To investigate the screening and diagnosis of neonatal congenital hypothyroidism (CH) in Ningbo from 2011 to 2014. To understand the screening situation of the disease in this area and to further screen the future Provide a valid basis. Methods The time-dependent immunofluorescence assay (DELFIA) was used to screen the blood of the newborn born in Ningbo city from 2011 to 2014. The results of TSH, free T3 (FT3), free T4 (FT4) ) Review to confirm. Results From 2011 to 2014, the number of CH screening in Ningbo was 89 619, 95 313, 89 469 and 87 312 respectively. The number of CH diagnosed in Ningbo was 61, 86, 58 and 68 respectively. CH morbidity were 68.07 / 100000, 90.23 / 100000, 64.83 / 100000, 77.88 / 100000, respectively. There was no significant difference in the incidence of CH in the years after the χ2 trend test. The recall rate of CH-positive persons in four years was 97.24%, 98.82%, 98.38% and 98.63% respectively, and 109 positive specimens were called out. Conclusion The incidence of CH in Ningbo is high. Neonatal screening is an effective measure for the early diagnosis of CH. An effective screening, recall and follow-up system is established to reduce the morbidity and mortality of children with CH, thereby improving the quality of the birth population.