中山地区新生儿先天性甲状腺功能减低症筛查结果分析

目的探讨不同性别、胎龄、出生体质量新生儿与先天性甲状腺功能减低症(CH)患病的关系及其促甲状腺激素(TSH)水平人群分布特点,指导临床筛查工作。方法对2014-2018年中山地区新生儿CH筛查结果进行回顾性分析,采用单因素分析比较不同性别、胎龄、出生体质量新生儿间CH发病率差异及TSH水平人群分布情况。结果筛查239006例新生儿,确诊CH 139例,发病率为0.058%(139/239006)。过期产儿CH发病率高于足月儿,差异有统计学意义(P<0.05)。新生儿TSH水平呈右偏态分布,不同性别、胎龄、出生体质量新生儿TSH水平单侧95%参考值范围均不同,各组人群TSH水平比较,差异均有统计学意义(P<0.001)。结论新生儿疾病筛查能有效帮助CH患儿早期诊断,过期产是CH发病的影响因素,临床医生在实际工作中还可将新生儿TSH水平人群分布特点纳入参考,做好CH的筛查工作。

Analysis of neonatal screening results for congenital hypothyroidism in Zhongshan area

Objective To investigate the relationship between neonatal congenital hypothyroidism(CH)and gender,gestational age,birth weight and the distribution characteristics of thyrotropin(TSH)level in order to guide clinical screening.Methods Retrospective analysis was conducted on CH screening results of neonates in Zhongshan area from 2014 to 2018,and univariate analysis was used to compare the incidence rate of CH among different gender,gestational age and birth weight among neonates and the distribution of the level of TSH in population.Results A total of 239006 neonates were screened and 139 cases of CH were confirmed,with an incidence rate of 0.058%(139/239006).The morbidity of CH in post-term infants was higher than that in full-term infants,and the difference was statistically significant(P<0.05).The TSH level of neonates represent the right skewed distribution,and the unilateral 95%reference range of TSH level of neonates of different genders,gestational age and birth weight was different,and the difference in TSH level of each group was statistically significant(P<0.001).Conclusion Neonatal disease screening can effectively help early diagnosis of infants with CH,and older gestational age is the influencing factor of CH.In practical work,clinicians can also take the distribution characteristics of TSH level in neonates as a reference,and do well in the prevention of CH.