先天性甲状腺功能减低症45例影响因素分析

目的 了解先天性甲状腺功能减低症(CH)发病情况及其影响因素,为CH的防治提供依据。方法 选取2015年1月—2019年12月本地区进行新生儿疾病筛查的新生儿进行问卷调查,分析本地区CH发病率及分布情况。应用单因素及多因素Logistic回归分析影响CH发病的相关因素。结果 2015—2019年进行新生儿疾病筛查人数总共为127 524例,确诊为CH患儿45例,5年CH总体发病率为35.29/10⁵。冬春季CH发病率高于夏秋季,但差异无统计学意义(χ²=0.884,P=0.347);早产儿CH发病率最高,发病率为251.68/10⁵(18/7 152),早产儿CH发病率高于足月儿20.93/10⁵(25/119 467),差异有统计学意义(χ²=105.839,P<0.001)。多因素Logistic回归分析显示,低出生体重(OR=3.172,95%CI:2.185～8.116,P=0.012)、早产(OR=2.662,95%CI:1.904～7.115,P=0.008)、合并妊娠期糖尿病(OR=1.973,95%CI:1.362～4.950,P=0.037)、合并妊娠期高血压疾病(OR=1.892,95%CI:1.207～4.216,P=0.024)、孕期用药史(OR=2.350,95%CI:1.802～6.713,P=0.016)、孕期射线接触史(OR=2.712,95%CI:1.938～7.346,P=0.028)及孕期碘摄入量不足(OR=4.120,95%CI:2.713～9.150,P<0.001)是CH发病的危险因素(P<0.05)。结论 本地区CH发病率较高,影响CH发病的危险因素较多,应根据这些因素制定预防措施,以减少CH发病。

Analysis of the influencing factors for congenital hypothyroidism in 45 infants

Objective To investigate the incidence and influencing factors of congenital hypothyroidism (CH), so as to provide basis for the prevention and treatment of CH. Methods From January 2015 to December 2019, the newborns undergoing neonatal disease screening in local region were enrolled in this study, and the incidence rate and distribution of CH were analyzed. Univariate and multivariate Logistic regression analysis methods were used to analyze the related factors of CH. Results The total number of neonatal screening from 2015 to 2019 was 127 524, of whom 45 cases were diagnosed with CH, and the overall incidence rates of CH in 5 years was 35.29/10⁵. The incidence rate of CH in winter and spring were higher than that in summer and autumn, but the difference was not statistically significant (χ²=0.884, P=0.347). The incidence rates of CH in preterm infants was the highest (251.68/10⁵), significantly higher than that of full-term infants(20.93/10⁵,χ²=105.839, P＜0.001).Multivariate Logistic regression analysis showed that low birth weight(OR=3.172, 95%CI: 2.185-8.116, P=0.012), premature delivery(OR=2.662, 95%CI: 1.904-7.115, P=0.008), gestational diabetes mellitus(OR=1.973, 95%CI:1.362-4.950, P=0.037), pregnancy induced hypertension(OR=1.892, 95%CI: 1.207-4.216, P=0.024),medication history(OR=2.350, 95%CI: 1.802-6.713, P=0.016), radiation exposure history(OR=2.712, 95%CI:1.938-7.346, P=0.028) and iodine deficiency during pregnancy(OR=4.120, 95%CI: 2.713-9.150, P＜0.001) were the risk factors of CH (P<0.05). Conclusions The incidence rate of CH is high in local region, and there are many risk factors that affect the incidence rates of CH. So it is supposed to make preventive measures based on these factors to reduce the incidence of CH.