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目的:了解河南省先天性甲状腺功能减低症(congenita1hypothyroidism,CH)的发病趋势。方法:分析河南省2005年至2013年CH的筛查结果。收集河南省出生72h至7天内充分哺乳的新生儿足跟血滤纸干血片,采用时间分辨荧光免疫分析法检侧促甲状腺激素(TSH)水平进行CH筛查,筛查阳性病例采用化学发光法检侧血清中游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、总三碘甲状腺激素(TT3)、总四碘甲状腺激素(TT4)及促甲状腺激素(TSH)水平,确诊病例按疾病诊疗常规进行治疗和随访。结果:河南省2005年1月至2013年12月9年间共筛查新生儿3504577例,确诊CH 1342例,总发病率为0.383‰。2005年至2007年CH发病率为0.242‰,2008年至2010年CH发病率为0.291‰,2011年至2013年CH发病率为0.421‰。2008年至2010年CH发病率较2005年至2007年有明显上升趋势,差异有统计学意义(P<0.05);2011年至2013年CH发病率较2008年至2010年亦有明显上升趋势,差异同样有统计学意(P<0.05)。结论:河南省CH发病率呈上升趋势,可能与标本量逐年增加,筛查面逐年扩大,漏筛查率减低及可疑阳性患儿召回率增加等因素有关~([1])。
Objective: To investigate the incidence of congenital hypothyroidism (CH) in Henan province. Methods: The screening results of CH from 2005 to 2013 in Henan Province were analyzed. Collected from 72h to 7 days after birth in Henan Province were fully breast-fed neonatal hematology hematology paper dried blood films, the use of time-resolved fluorescent immunoassay detection of thyroid stimulating hormone (TSH) level CH screening screening positive cases using chemiluminescence Serum levels of free triiodothyronine (FT3), free tetraethionine (FT4), total triiodothyronine (TT3), total tetraiodothyroid hormone (TT4) and thyrotropin (TSH) Level, confirmed cases according to the disease treatment routine treatment and follow-up. Results: A total of 3,504,577 newborns were screened from January 2005 to December 2013 in Henan Province. A total of 1342 CH cases were diagnosed with a total incidence of 0.383 ‰. CH incidence was 0.242 ‰ between 2005 and 2007, CH incidence was 0.291 ‰ between 2008 and 2010, CH incidence was 0.421 ‰ between 2011 and 2013. The incidence of CH increased significantly from 2008 to 2010 than that from 2005 to 2007, with a significant difference (P <0.05). From 2011 to 2013, CH incidence also showed a significant upward trend from 2008 to 2010, The differences were also statistically significant (P <0.05). Conclusions: The prevalence of CH in Henan Province is on the rise, which may be related to the increasing of specimen size, the increasing of screening screen, the decreasing of screening rate and the increase of recall rate of suspicious positive children ([1]).