Panamonta Ouyporn, Tuksapun Sukanya, Kiatchoosakun Pakaphan, Jirapradittha Junya, Kirdpon Wichitr, Loapaiboon Malinee
Department of Pediatrics, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen 40002, Thailand.
J Med Assoc Thai. 2003 Oct;86(10):932-7.
Between January 2000 and December 2002, 9,558 of 10,868 live births at Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand, were screened for congenital hypothyroidism (CH). Dried blood spot thyroid stimulating hormone (TSH) was collected at age 48 hours or older. The cut-off TSH level for recall test was > 25 mu/L. Serum thyroxine (T4), Free T4 and TSH were performed during the confirmatory test. Six of 24 infants recalled for confirmatory thyroid function tests had abnormal tests. Primary CH was confirmed in 3 infants and thyroxine treatment was given. Two of the three infants had thyroid dysgenesis, one had normal thyroid gland. Three infants showed borderline CH from the confirmatory test, only one had borderline CH from the second confirmatory test and also received thyroxine treatment. Twenty infants with false positives during the screening and confirmatory tests were regularly followed-up for growth, development and thyroid function tests. The incidence of primary CH in this sole tertiary care government hospital in Northeast Thailand was 1:3,186. Routine newborn CH screening would ensure early detection and treatment.
2000年1月至2002年12月期间,泰国孔敬府孔敬大学诗里那琳医院的10,868例活产婴儿中有9,558例接受了先天性甲状腺功能减退症(CH)筛查。在出生48小时及以上时采集干血斑促甲状腺激素(TSH)。召回检测的TSH临界值水平为>25 μU/L。在确诊检测期间进行血清甲状腺素(T4)、游离T4和TSH检测。被召回进行甲状腺功能确诊检测的24例婴儿中有6例检测结果异常。3例婴儿确诊为原发性CH并接受了甲状腺素治疗。这3例婴儿中有2例存在甲状腺发育不全,1例甲状腺正常。3例婴儿在确诊检测中显示临界CH,只有1例在第二次确诊检测中显示临界CH且也接受了甲状腺素治疗。20例在筛查和确诊检测中出现假阳性的婴儿定期接受生长、发育和甲状腺功能检测随访。泰国东北部这家唯一的三级护理政府医院中,原发性CH的发病率为1:3,186。常规新生儿CH筛查可确保早期发现和治疗。