新生儿先天性甲状腺功能异常发病率与胎龄、出生体重关系的研究

目的探讨广西地区先天性甲状腺功能异常（包括先天性甲状腺功能减低症（CH）和高TSH血症）发病率与胎龄、出生体重的关系。方法对2009年9月～2010年12月广西新生儿疾病筛查中心筛查的新生儿,凡滤纸血促甲状腺素（TSH）〉8.0mIU/L者予以召回,进行甲状腺功能检查。结果 2009年9月～2010年12月共筛查220 844人,确诊先天性甲状腺功能异常200人,发病率为1/1104。其中,早产儿（胎龄〈37周）发病率为1/449,足月儿（37≤胎龄≤42周）发病率为1/1189,过期产儿（胎龄〉42周）发病率为1/206,过期产儿发病率高于早产儿及足月产儿（P〈0.05）。低出生体重儿﹙〈2500g）发病率为1/407,正常体重儿（2500～4000g）发病率为1/1236,巨大儿（〉4000g）发病率为1/376,低出生体重儿及巨大儿的先天性甲状腺功能异常发病率明显高于正常体重儿（P〈0.01）。结论先天性甲状腺功能异常的发病率与胎龄、出生体重密切相关,过期产儿、巨大儿、低出生体重儿的发病率较高。注意孕期保健防止过期产儿、巨大儿、低出生体重儿,对降低先天性甲状腺功能异常的发生有重大意义。

Study on therelationship of congenital thyroid dysfunction with gestational age and body weight

Objective:To investigate the relationship of congenital thyroid dysfunction(including congenital hypothyroidism(CH) and high thyrotropin hyperlipidemia)with birth weight and gestational age in Guangxi region.Methods:All newborns were screened in Neonatal screening center of GuangXi(from 2009-9 to 2010-12).The thyroid stimulating hormone(TSH) was measured by time-resolved fluorescence immunoassay(TRFIA).If TSH was > 8.0mIU / L,the infant was recalled for detecting thyroid function.Results:From 2009-9 to 2010-12,a total of 220 844 infants were screened,of whom 200 were diagnosed as congenital thyroid dysfunction.The prevalence rate was 1/1104.Among the 200 cases,the prevalence of premature infants(gestational age <37 weeks),term infants(gestational age 37 to 42 weeks) and expired infants(gestational age > 42 weeks) was 1/449,1/1189,1/206,respectively.The prevalence of expired infants was significantly higher than that in the other two groups(P<0.05).The prevalence of low birth weight infants(<2500g),normal weight infants(2500-4000g) and great infants(> 4000g) was 1/407,1/1236,1/376,respectively.The prevalence of low birth weight infants and great infants was significantly higher than normal weight infants(P<0.01).Conclusion: The prevalence of congenital thyroid dysfunction is associated with the gestational age and birth weight.Expired births,great infants and low birth weight infants have a hinger prevalence of congenital thyroid dysfunction.Therefore,attention to prenatal care to prevent the expiration births,great children,low birth weight children,to reduce the prevalence of congenital thyroid dysfunction has great significance.