摘要
目的：探讨B超检查在先天性甲状腺功能退（ congenital hypothyroidism,CH）患儿的诊断、治疗、预后判断的价值。方法2009年9月21日至2010年9月20日在我中心筛查确诊的54例患儿B超检查结果的分析,了解B超检查在CH患儿的诊断、治疗、预后判断的价值。采用时间分辨免疫荧光分析法（ Tr-FIA ）检测滤纸血斑中的促甲状腺素（ TSH）,对召回的可疑患儿采用化学发光免疫法检测血清甲状腺功能,确诊后B超检测甲状腺情况,同时给予左甲状腺素钠片治疗,正规治疗1~3年后根据情况停药观察,重新评估暂时性CH还是永久性CH。结果2010年度在成都市新生儿疾病筛查中心筛查新生儿169928名,确诊CH62例,发病率1/2741。在我中心治疗的54例中, B超检查未见异常31例,占57．41%；异常23例,占42．59%。重新评估确定为暂时性CH的22例病,B超检查异常的3例,占13．63%；永久性CH32例,B超检查异常20例,占32．50%,两者经检验差异有统计学意义（P〈0．05）。结论2010年成都市CH发病率为1/2741,低于本中心平均水平（1/2335）。 B超检查为CH 的辅助诊断手段,也可以作为 CH患儿的预后判断的指标之一。
Objective From September 21, 2009 to September 20, 2010 the neonatal screening center in Chengdu con-firmed 54 cases of congenital hypothyroidism（ CH） in children with B-ultrasound analysis. The purpose was to learn the important role of B-ultrasound test played in the diagnosis, treatment and prognosis of children with CH. Methods The method was using time-resolved fluorescence analysis（ Tr-FIA） to detect thyrotropin（ TSH） in the blood spotson the filter paper. The screening center then recalled the suspected patients, using chemiluminescence immunoassay to check the blood serum thyroid function. After the diagnosis CH, the center performed B-ultrasound examination to check the thyroid condition, while giving levothyroxine sodium tablets to the patients. After the treatment 1 to 3 years, the center could withdraw the tablets based on patients’ condition, then ob-serving how the patients reacted after the withdrawal. The center could re-evaluate if the CH was temporary or permanent. Results From September 21, 2009 to September 20, 2010, the neonatal screening center in Chengdu screened the total of 169,928 newbo-rns and diagnosed 62 CH cases. The incidence rate was 1 out of 2741. Among the 54 treated patients, 31 of them showed no ab-normalities with B-ultrasound test, accounting for 57. 41% of the total treated patients, while 23 cases showed abnormalities, ac-counting for 42. 59%. 22 patients with CH were identified as temporary after the re-evaluation, among which 3 showed abnormali-ties with B-ultrasound test, accounting for 13. 63% of the total patients with temporary CH. 32 patients with CH were identified as permanent after the re-evaluation, among which 20 showed abnormalities with B-ultrasound test, accounting for 32. 50% of the to-tal patients with permanent CH. The difference in the results was considered significant by test. Conclusion 1. The CH inci-dence rate of 2010 in Chengdu was 1 out of 2741, lower than the center average. 2. B-ultrasound test could be used as a supple-mentary meth
出处
《四川医学》
CAS
2015年第9期1338-1340,共3页
Sichuan Medical Journal
