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目的提高人口素质,预防智力障碍,减少残疾儿发病率。方法在新生儿出生后72h采足跟血3滴,直接滴于美国产S&S903滤纸上。采用DELFIA法进行TSH检测,确诊用ACS 180 Plus全自动化学发光分析仪测定血清T3、T4、FT3、FT4、TSH值。结果①共收集全市78家医院标本27420份,初筛阳性者65例,发现患儿14例,检出率为1/1958。②检出的CH中男性7例,女性7例,其中农村9例,城市5例。③14例CH患儿分别在生后7-14天内经血清学检查确诊,确诊后立即予以左旋甲状腺素片8-10μg/kg/日进行治疗。患儿在1月左右复查血清T3、T4、FT3、FT4、TSH值均达到正常值,生长发育基本正常。结论①我市发病率高于全国统计率,可能与标本量及经济条件有关。而CH发生率以靖州县最高,可能是与该县新生儿筛查率达90%有关。原因需进一步探讨。②农村出生新生儿筛查率低,原因与经济条件有关。③部分筛查有问题的新生儿家长不愿带新生儿来及时确诊,与新生儿家长对疾病的知晓少有关。④筛查结果表明新生儿筛查是早期发现CH的最有效方法,只有早诊断早治疗,才可能避免智力障碍的发生,减少残疾儿,才能提高出生人口素质。
Objective To improve the quality of population, prevent mental retardation and reduce the incidence of disabled children. Methods The newborn was collected at 72h after birth and blood 3 drops, directly on the United States S & S903 filter paper. TSH was detected by DELFIA, and serum T3, T4, FT3, FT4 and TSH were determined by ACS 180 Plus automatic chemiluminescence analyzer. Results ① A total of 27,420 specimens of 78 hospitals in the city were collected. Among them, 65 were initially screened and 14 were found, the detection rate was 1/1958. ② CH was detected in 7 males and 7 females, of whom 9 were in rural areas and 5 in urban areas. ③ 14 cases of CH children were diagnosed by serological examination within 7-14 days after birth, and treated with levothyroxine 8-10 μg / kg / day immediately after diagnosis. Children in about January review of serum T3, T4, FT3, FT4, TSH values have reached a normal value, growth and development was normal. Conclusion ① The incidence rate in our city is higher than the national statistical rate, which may be related to the sample size and economic conditions. The highest incidence of CH in Jingzhou County may be related to the county’s newborn screening rate of 90%. The reason needs to be further explored. ② low birth rate of newborn babies born in rural areas, the reasons and economic conditions. ③ part of the screening of newborns with problems do not want to bring newborns to timely diagnosis, and neonatal parents know less about the disease. ④Screening results show that neonatal screening is the most effective method of early detection of CH. Only early diagnosis and early treatment can prevent the occurrence of mental retardation and reduce disabled children in order to improve the quality of the birth population.