先天性甲状腺功能减低症发病及诊治分析

目的:了解深圳地区先天性甲状腺功能减低症(先天性甲低)的发病率、发病特点及诊断特点。方法:调查2005年9月~2007年6月在深圳市各产科医院出生的新生儿中通过新生儿疾病筛查发现并确诊的先天性甲低患儿的数量、分布区域、孕母情况等流行病学特点,观察甲低患儿的早期临床表现、生长发育尤其神经运动发育情况和甲状腺功能实验室检查及超声改变等。结果:共筛查192053例新生儿,确诊先天性甲低患儿97例,发病率1∶1 980,发病患儿以非户籍暂住人口、外来务工人员所生子女居多,以宝安、龙岗两区居多。患儿早期可有吸吮慢、喂养困难、腹胀、黄疸消退延迟、哭声小、声音嘶哑等非特异临床表现;出生72h足底血干血片法筛查TSH,对TSH增高者进一步检验血液TSH及T3、T4,确诊年龄为14~50天,平均27.3天。部分患儿甲状腺超声有甲状腺发育不良、甲状腺弥漫性增生性改变或血流改变等。确诊者立即开始治疗。结论:深圳地区暂住人口分娩的新生儿先天甲低发病比例较高,应重视其饮食、居住、生活及孕期保健。通过新生儿筛查可早期诊断先天性甲低、及早开展治疗。

Research on diagnosis and incidence of congenital hypothyroidism

Objective:To study the incidence,clinical characters and diagnosis of congenital hypothyroidism(CH) in Shenzhen.Methods:To investigate the distribution of patients diagnosed CH from September 2005 to June 2007 in Shenzhen,maternal condition during pregnancy,early clinical presentation,growth and development,and the result of ultrasonography.Results:The incidence of CH in Shenzhen was 1:1980.The most parents of these babies were temporary resident in Shenzhen.Early clinical features such as poor feeding and ...