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目的探讨筛查方法对肇庆地区新生儿先天性甲状腺功能减低症的控制作用。方法分析肇庆地区2007年11月至2009年3月期间新生儿先天性甲状腺功能减低症(CH)的筛查结果。通过收集肇庆市新生儿出生3d时的足跟血滤纸干血斑标本,检测促甲状腺素(TSH)筛查先天性甲状腺功能减低症。确诊指标:采用化学发光免疫分析法检测血清中TSH、FT4、FT3水平。阳性者按疾病诊疗常规进行确诊和治疗。结果共筛查新生儿32127例,共筛出CH可疑病例39例,初筛阳性率1∶824,可疑患儿召回23例,召回率为58.9%。召回的23例中血清检测确诊CH13例,5例为高TSH血症,CH检出率为1∶2471。结论新生儿滤纸血斑TSH检测采用酶荧光免疫分析法,确诊患儿采用化学发光免疫分析法,两种均为较好的方法。CH治疗时间越早预后越佳。需要重新确定本市的CH的初筛阈值,减少漏诊。
Objective To investigate the control effect of screening methods on congenital hypothyroidism in neonates in Zhaoqing area. Methods The screening results of neonatal congenital hypothyroidism (CH) in Zhaoqing from November 2007 to March 2009 were analyzed. By collecting blood samples of heel hematophagoides in Zhaoqing City at 3 days after birth, thyroid-stimulating hormone (TSH) was screened for congenital hypothyroidism. Confirmatory index: Chemiluminescent immunoassay was used to detect serum TSH, FT4, FT3 levels. Positive by the diagnosis and treatment of disease diagnosis and treatment routine. Results A total of 32,127 newborns were screened, of which 39 cases were suspected CH. The positive rate of primary screening was 1: 824, and 23 cases of suspicious children were recalled. The recall rate was 58.9%. The recall of 23 cases of serum test confirmed CH13 cases, 5 cases of high TSH hyperlipidemia, CH detection rate of 1:2471. Conclusion Neonatal filter paper TSH detection using enzyme fluorescence immunoassay, the diagnosis of children using chemiluminescence immunoassay, two are better. The earlier the CH treatment, the better the prognosis. Need to re-determine the city’s CH screening threshold to reduce missed diagnosis.