新生儿先天性甲状腺功能减低症筛查10年回顾

目的了解武汉市CH发病率及10年筛查情况,总结经验、查找不足以指导今后筛查工作。方法CH筛查方法为新生儿出生后72h、采足跟末梢血制成干血滤纸片,用EIA法或ELISA法检测血片中TSH含量,将EIA法TSH值≥10mIU/L或ELISA法≥20mIU/L的新生儿判为筛查阳性,并召回确诊。结果武汉市10年来,共筛查新生儿271221例,确诊CH患儿125例,CH发病率为0.461‰,男、女之比为1∶1.23,10年CH发病率无显著上升或下降趋势;用ELISA法和用EIA法检测的CH发病率之间无显著差异。结论武汉市是CH高发地区,各级政府部门和妇幼保健机构应加强新生儿疾病筛查网络建设及管理,进一步提高筛查覆盖率;业务技术指导部门应加强标本采集和实验人员的培训;选择适当的筛查、实验方法,完善质控机制;降低CH患儿发生率,提高武汉市出生人口素质。

Analysis and study of newborn congenital hypothyroidism screening in Wuhan for 10 years

Objective:To explore the morbidity and screening of congenital hypothyroidism (CH) in Wuhan for 10 years, to find the better way to guide the future screening.Methods:A drop of plantar blood from newborns 72 hours after delivery was obtained to put onto a filter paper and make it dry to test blood levels of TSH by ELISA method at former 4 years and by EIA method at later 6 years respectively. The test results were regarded as positive when TSH value ≥10 mIU/L by EIA or TSH value≥20 mIU/L by ELISA, and great majority positive cases were called back for diagnosis test.Results:Total 271 221 cases were screened in WuHan for 10 years, Among them 125 cases were diagnosed CH, the CH morbidity rate was 0.461‰, male and female cases ratio was 1∶1.23, the trends of morbidity was no significant increase or decrease througout 10 years; There was no significant differences between ELISA method and EIA method when calculat CH morbidity.Conclusion:Wuhan is a high CH morbidity city, government and women and children health care institutes at all levels should strengthen the screen network building and management of neonatal disease screening, make the screening more accessible, extend screening coverage further; guidance department should strengthen technical guidance in specimen collection and lab personnel training; adopt qualified screening test methods, perfect quality control mechanism, reduce the birth defect occurrence to improve the quality of the population in Wuhan.