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新生儿先天性甲状腺功能减退症、先天性肾上腺皮质增生症和葡萄糖-6-磷酸脱氢酶缺乏症筛查的初步报告:昌迪加尔经验。

Preliminary report on neonatal screening for congenital hypothyroidism, congenital adrenal hyperplasia and glucose-6-phosphate dehydrogenase deficiency: a Chandigarh experience.

机构信息

Genetic Centre, Government Medical College & Hospital, Sector 32, Chandigarh, India 160031.

出版信息

Indian J Pediatr. 2010 Sep;77(9):969-73. doi: 10.1007/s12098-010-0150-x. Epub 2010 Aug 27.

DOI:10.1007/s12098-010-0150-x
PMID:20799077
Abstract

OBJECTIVE

To establish newborn screening in Indian scenario that could lay a framework for future such initiatives. Three disorders namely, congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH) and glucose-6-phosphate dehydrogenase deficiency (G-6-PDD) were selected for a preliminary study for newborn screening.

METHODS

Heel-prick blood samples were collected from live-born neonates at 24-48 h of birth as a part of a screening program after prior written consent from the parents. Blood levels of glucose-6-phosphate-dehydrogenase enzyme (G-6-PD), thyroid-stimulating hormone (TSH) and 17-α-OH progesterone (17-OHP) were measured using DELFIA time resolved fluoroimmunoassay.

RESULTS

Six thousand eight hundred and thirteen (6,813) neonates (86.3%), out of a total of 7,893 live births in our institute during the period May'2007 through July'2009, were screened for CAH, CH and G6PD deficiency. Major reason for missing samples was early discharge of the neonates and admission to the neonatal intensive care unit. G-6-PD deficiency was confirmed in 61 cases, congenital hypothyroidism (CH) in 2 cases and congenital adrenal hyperplasia (CAH) in 1 neonate, accounting for an incidence of 1/112 for G-6-PDD, 1/ 3400 for CH and 1/6813 for CAH.

CONCLUSIONS

Preliminary data on prevalence of various genetic disorders viz. G-6-PDD, CH and CAH in the population of this region revealed that G-6-PDD is most prevalent disorder followed by CH and CAH. More efforts need to be undertaken to create awareness and emphasis on significance of preventive testing to make screening a successful program in India.

摘要

目的

在印度建立新生儿筛查体系,为未来的此类举措奠定框架。选择三种疾病,即先天性甲状腺功能减退症(CH)、先天性肾上腺皮质增生症(CAH)和葡萄糖-6-磷酸脱氢酶缺乏症(G-6-PDD),作为新生儿筛查的初步研究。

方法

作为筛查计划的一部分,在获得父母的书面同意后,于出生后 24-48 小时采集活产新生儿足跟血样。使用 DELFIA 时间分辨荧光免疫分析法测量葡萄糖-6-磷酸脱氢酶(G-6-PD)、促甲状腺激素(TSH)和 17-α-羟孕酮(17-OHP)的血液水平。

结果

在 2007 年 5 月至 2009 年 7 月期间,我院共有 7893 例活产儿,其中 6813 例(86.3%)接受了 CAH、CH 和 G6PD 缺乏症的筛查。样本缺失的主要原因是新生儿过早出院并入住新生儿重症监护病房。共确诊 61 例 G-6-PD 缺乏症、2 例先天性甲状腺功能减退症(CH)和 1 例先天性肾上腺皮质增生症(CAH),G-6-PDD 的发病率为 1/112,CH 为 1/3400,CAH 为 1/6813。

结论

本地区人群中各种遗传疾病(如 G-6-PDD、CH 和 CAH)的患病率初步数据表明,G-6-PDD 是最常见的疾病,其次是 CH 和 CAH。需要进一步努力提高认识,并强调预防性检测的重要性,使筛查在印度成为一项成功的计划。

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