新生儿先天性甲状腺功能低下症与出生体重及胎龄关系研究.docVIP

新生儿先天性甲状腺功能低下症与出生体重及胎龄关系研究 　　【摘要】 目的 探讨新生儿先天性甲状腺功能低下症（CH）与出生体重及胎龄关系。方法 1500例实施先天性甲状腺功能低下症筛查的新生儿， 根据新生儿胎龄分为早产组（42周， 351例）；根据出生儿出生体重分为低出生体重组（4000 g， 401例）。新生儿出生后应用时间分辨荧光免疫方法（TRFIA）测定足跟血斑的促甲状腺素（TSH）指标。对检测阳性患儿实施甲状腺功能检测。评估出生体重及胎龄与新生儿先天性甲状腺功能低下症的关系。结果 超龄组新生儿先天性甲状腺功能低下症发病率为3.70%显著高于早产组的1.68%与足月组的1.53%， 差异具有统计学意义（P0.05）。正常体重组新生儿先天性甲状腺功能低下症发病率为0.60%， 低于低出生体重组的3.75%与巨大儿的3.99%， 差异具有统计学意义（P0.05）。结论 通过对新生儿实施先天性甲状腺功能低下症筛查， 超龄??出生体重异常新生儿患先天性甲状腺功能低下?Y几率高， 孕期有效干预避免超龄与出生体重异常对于降低新生儿先天性甲状腺功能低下症具有重要临床指导意义。 　　【关键词】 先天性甲状腺功能低下症；出生体重；胎龄；关系 　　【Abstract】 Objective To explore the correlation between neonatal congenital hypothyroidism （CH） and birth weight and gestational age. Methods A total of 1500 newborns with congenital hypothyroidism were divided by neonatal gestational age into preterm group （42 weeks， 351 cases）， and they were also divided by birth weight into low birth weight group （2500 g， 　　267 cases）， normal weight group （2500～4000 g， 832 cases） and fetal macrosomia group （4000 g， 401 cases）. Thyrotropin （TSH） index of foot root speck was determined by time-resolved fluorescence immunoassay （TRFIA）method after postnatal newborns， and children with positive test results received thyroid function test. Evaluation was made on correlation between birth weight， gestational age and neonatal congenital hypothyroidism. Results The overage group had obviously higher incidence of neonatal congenital hypothyroidism as 3.70% than 1.68% in preterm group and 1.53% in mature group， and the difference had statistical significance （P0.05）. The normal weight group had lower incidence of neonatal congenital hypothyroidism as 0.60% than 3.75% in low birth weight group and 3.99% in fetal macrosomia group， and the difference had statistical significance （P0.05）. Conclusion Through screening of neonatal congenital hypothyroidism， overage and abnormal birth weight newborns have high congenital hypothyroidism rate. Effective intervention can avoid overage and abnormal birth weight during pregnancy， an