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菲律宾新生儿先天性甲状腺功能减退症(CH)筛查。菲律宾新生儿筛查研究小组。

Screening for congenital hypothyroidism (CH) among Filipino newborn infants. Philippine Newborn Screening Study Group.

作者信息

Fagela-Domingo C, Padilla C D, Cutiongco E M

机构信息

College of Medicine and Philippine General Hospital, University of the Philippines, Manila.

出版信息

Southeast Asian J Trop Med Public Health. 1999;30 Suppl 2:20-2.

Abstract

From June 1996 to June 1998 a total of 62.841 newborn infants were screened for congenital hypothyroidism with thyroid stimulating hormone assay as a primary test. The method used was an immunofluorescent assay using the DELFIA TSH Kit on dried blood specimens collected by heelprick on filter paper. All infants with TSH values greater than 20 microU/ml were retested. If the results remained abnormally high, confirmatory testing was done by radioimmunoassay. All infants who were confirmed to be hypothyroid were referred to pediatric endocrinologists for initial management. The overall weighted incidence of congenital hypothyroidism obtained in this study was 0.000277 (95% CI; 0.000122 - 0.000432) or 1:3,610 which may be higher than that reported by most screening programs worldwide. The recall rate was 0.16%. The higher recall rate may be explained by early testing in a number of cases and by the possibility of iodine deficiency in some of the mothers. On the basis of the results of this study, we would recommend (1) screening on a greater number of infants to verify the incidence of CH and (2) establishing normal TSH values at different hours of life to improve our recall rate.

摘要

1996年6月至1998年6月,共有62841名新生儿接受先天性甲状腺功能减退症筛查,以促甲状腺激素检测作为主要检测方法。所采用的方法是使用DELFIA TSH试剂盒对通过足跟采血采集在滤纸上的干血标本进行免疫荧光检测。所有促甲状腺激素值大于20微单位/毫升的婴儿均进行复查。如果结果仍然异常偏高,则通过放射免疫测定法进行确诊检测。所有确诊为甲状腺功能减退症的婴儿均被转诊至儿科内分泌专家处进行初始治疗。本研究得出的先天性甲状腺功能减退症的总体加权发病率为0.000277(95%可信区间:0.000122 - 0.000432),即1:3610,这可能高于全球大多数筛查项目报告的发病率。召回率为0.16%。较高的召回率可能是由于一些病例检测较早以及部分母亲存在碘缺乏的可能性所致。基于本研究结果,我们建议:(1)对更多婴儿进行筛查以核实先天性甲状腺功能减退症的发病率;(2)确定不同生命时刻的促甲状腺激素正常数值以提高我们的召回率。

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