新生儿高促甲状腺素血症446例临床转归研究

目的 通过对新生儿高促甲状腺素血症患儿转归的研究,为先天性甲状腺功能减低症的治疗工作提供依据。 方法 对446例经新生儿疾病筛查可疑先天性甲状腺功能减低症、第1次就诊时静脉血清促甲状腺激素(thyrotropin,TSH)浓度为5~20 mU/L、FT4浓度正常的新生儿随访至3~6岁后,评估体格发育情况与甲状腺功能。 结果 1)经3~6年随访,最后确诊永久性甲状腺功能低下1例,高TSH血症16例,甲状腺功能完全正常429例;2)随访起始与结束时TSH浓度比较,Z值分别为:2.90,5.41,6.45,P值均为＜0.01。 结论 经新生儿疾病筛查的高TSH血症患儿多数可恢复正常,少数应严密随访,以早期确诊及治疗。

Research of clinical outcome in 446 neonates with hyperthyrotropinemia

Objective To improve the treatment level of congenital hypothyroidism through researching the clinical outcome of neonatal hyperthyrotropinemia. Methods 446 hyperthyrotropinemia neonates were follow up whose concentration of thyrotropin were 5~20 mU/L and concentration of free thyroxine were normal.Their body growth level and thyroid function were evaluated in 3~6 years old. Results Among them,16 cases were hyperthyrotropinemia,429 cases were normal,and only one child were diagnosed permanent congenital hypothyroidism.Significant differences were found in concentration of thyrotropin between the outset and the end of follow-up. Conclusions With growing-up,the most of these neonates' thyroid function are normal.There should be exactitude follow-up with neonatal hyperthyrotropinemia.Congenital hypothyroidism should be diagnosed and treated as early as possible in hyperthyrotropinemia.