广州地区早产儿先天性甲状腺功能低下症筛查结果分析

目的探讨早产儿与新生儿先天性甲状腺功能减低症（congenitalhypot hyroidism，CH）筛查各个阶段筛查结果的关系。方法选择2011年10月-2012年9月间进行新生儿筛查的干血片209860例，按照胎龄分为早产儿组、对照组1（足月儿组）、对照组2（过期产儿组）用免疫酶荧光法测定新生儿干血片促甲状腺素（thyroid stimulating hormone，TSH）值，筛查阳性患儿及时召回测定TSH、游离三碘甲状腺原氨酸（free triiodothyronine，FT3）、游离甲状腺素（free thyroxine，FT4）并作出诊断，并对早产儿组与对照组初筛阳性结果和确诊结果进行分析。结果早产儿组的初筛阳性率要低于足月儿组和过期产儿组，差别有统计学意义，早产儿组CH发病率要高于足月儿，差别有统计学意义，不同胎龄、出生体重早产儿的CH发病率存在线性相关，胎龄越小、出生体重越低，CH发病率越高。结论为了防止早产儿TsH延迟升高所带来的筛查假阴性，在新生儿筛查阶段对早产儿宜推迟采集测定足跟血TSH，加强围生期的保健和管理，减少早产儿的出生对于降低CH发病率，提高出生人口素质有着积极的意义。

Relevent analysis of congenital hypothyroidism screening in preterm infants.

Objective： To study the influence of congenital hypothyroidism screening results in preterm infants. Methods： Detection of TSH concentration from blood specimens dried on filter paper by FEIA from October 2011 to September 2012, The neonates were divided into several groups accoridng to gestational age. And the neonates with positive results were recalled back for detectiqn of TSH, free triiodothyronine （FT3） and free thyroxine （FT4） for diagnosis. Results： A total of 209 860 infants were screened. The positive rate of TSH were significant difference in gestational age groups. The prevalence of CH were significant differenc between preterm infants groups and term infants groups. The prevalence of CH are linear Correlation in different gestational age and birth weight of preterm infants. The smaller the preterm gestation is and the lower the preterm birth weight is, the higher the prevalence of CH is. Conclusion： It is recommendable to delay determination of TSH for preterm infants and low birth weight in case of missed diagonosis of CH. In order to reduce the prevalence of CH. It is crucial to prevent preterm infants delivery which has the positive significance to improve the population quality.