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目的:了解先天性甲状腺功能低下症(congenitalhypothyroidsm,CH)的发病率、甲状腺变化、病因分类和治疗情况。方法:采集1999~2003年济宁市新生儿出生后72h血样滴于滤纸上,用酶免疫标记法测定促甲状腺素(TSH)含量;可疑阳性者取其静脉血,用放射免疫分析法测定血清TSH、T4、T3含量;同时用放射性核素99mTcO4甲状腺静态显像,确定甲状腺发育、位置和功能;确诊为CH患儿给予L-T4治疗并定期随访监测。结果:324444筛查血样中发现可疑患儿1092例,确诊CH163例,发病率1∶1999;其中132例CH甲状腺扫描显示甲状腺正常96例、发育不良17例、异位14例、缺如11例,甲状腺异常CH全部为永久性CH;107例病因分类的CH中,55例为永久性CH,42例为暂时性CH,10例失访未分类;治疗后CH患儿骨龄和智能发育正常。结论:济宁市CH发病率接近国内平均水平,甲状腺异常多发生在永久性CH中,规范的治疗可使CH预后良好。
Objective: To understand the incidence of congenital hypothyroidism (CH), thyroid changes, the cause of the classification and treatment. Methods: Blood samples were collected on filter paper at 72h after birth from 1999 to 2003 in Jining City. Thyrotropin (TSH) levels were determined by enzyme-linked immunosorbent assay (ELISA). Venous blood was collected from suspicious patients and radioimmunoassay was used to determine serum TSH , T4, T3 content; at the same time with the radionuclide 99mTcO4 thyroid static imaging to determine thyroid development, location and function; diagnosed as CH children given L-T4 treatment and regular follow-up monitoring. Results: There were 1092 suspicious children in 324444 blood samples, the diagnosis was CH163 cases, the incidence rate was 1:1999. Of the 132 thyroid thyroid glands, there were 96 cases of normal thyroid gland, 17 cases of dysplasia, 14 cases of ectopic, 11 cases of absent , Thyroid abnormal CH were all permanent CH; CH in 107 cases of CH, 55 cases were permanent CH, 42 cases were transient CH, 10 cases were not classified as follow-up; CH patients with normal bone age and intelligence development. Conclusion: The morbidity of CH in Jining City is close to the average level in the country. Thyroid abnormalities occur mostly in permanent CH, and standard treatment can make CH prognosis good.