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目的:分析影响新生儿先天性甲状腺功能减低症(Congenital hypothyroidism,CH)检出的因素,为提高CH检出率,减少漏诊,提供可借鉴的方法。方法:对比分析2002年1月~2005年12月间,不同年份新生儿筛查覆盖率和筛查率与CH检出率和发病率的关系;同时对比不同筛查切值和不同年份可疑阳性召回率与CH检出率的关系。结果:①随着新生儿筛查覆盖率和筛查率的逐年提高,CH的检出率逐年提高,CH的发病率逐年上升;②用正常新生儿滤纸干血片TSH97.5%的可信限作为筛查切值,其CH检出率高于用TSH99.0%的可信限作为筛查切值;③随着可疑阳性召回率的逐年提高,CH检出率逐年提高;④在29例CH病例中,早产儿2例,其中1例早产儿滤纸干血片TSH初筛值小于筛查切值。结论:新生儿筛查覆盖率、筛查率、筛查切值、可疑阳性患儿召回率以及新生儿早产均是影响新生儿CH检出的因素。
OBJECTIVE: To analyze the factors influencing the detection of congenital hypothyroidism (CH) in neonates, and to provide a reference for improving CH detection rate and reducing missed diagnosis. Methods: The relationship between neonatal screening coverage and screening rate and CH detection rate and incidence in different years from January 2002 to December 2005 were compared and analyzed. At the same time, different screening cut-off values and suspicious positives in different years Recall rate and CH detection rate of the relationship. Results: (1) The detection rate of CH increased year by year as the newborn screening coverage and screening rate increased year by year, and the incidence of CH increased year by year. (2) With the credibility of TSH97.5% As the screening cut-off value, the CH detection rate is higher than the TSH99.0% confidence limit as a screening cut-off value; ③ with the suspicious positive recall rate increased year by year, CH detection rate increased year by year; In CH cases, there were 2 cases of premature infants, of which 1 case of premature children filter paper dried blood TSH initial screening value less than the screening cut value. Conclusion: Neonatal screening coverage, screening rate, screening cut-off value, recall rate of suspicious positive children and neonatal preterm birth are all the factors that affect CH detection in neonates.