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蒙古国乌兰巴托先天性甲状腺功能减退症新生儿筛查的首次经验。

First Experiences with Newborn Screening for Congenital Hypothyroidism in Ulaanbaatar, Mongolia.

作者信息

Tsevgee Altantuya, Batjargal Khishigjargal, Munkhchuluun Tsolmon, Khurelbaatar Naranchimeg, Nansal Gerelmaa, Bulgan Oyun-Erdene, Nyamjav Sumberzul, Zagd Gerelmaa, Ganbaatar Erdenetuya

机构信息

Department of Pediatrics, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia.

Department of Pediatrics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi 329-0498, Japan.

出版信息

Int J Neonatal Screen. 2021 Jun 7;7(2):29. doi: 10.3390/ijns7020029.

Abstract

Congenital hypothyroidism (CH) is among the most common conditions leading to intellectual disability, which can be prevented by early detection through newborn screening (NBS). In Mongolia, a regional screening program for CH was launched in 2000, which was supported by the International Atomic Energy Agency (IAEA) for the Asia Pacific Region. In our present study, a total of 23,002 newborns from nine districts in Ulaanbaatar were screened between 2012 and 2020, by the measurement of the thyroid-stimulating hormone (TSH) from dried blood spots, sampled 24 to 72 h after birth. The level of TSH was measured by the DELFIA assay. The overall CH prevalence confirmed at birth was 1/2091. The female-to-male ratio for CH cases was 1.8:1. The majority of patients were asymptomatic (72.7% of CH cases); umbilical hernia and cold or mottled skin were reported symptoms in patients with CH (27.3%). Thyroid dysgenesis (hypoplasia and agenesis) was the most common etiology, with a total of nine cases (81.8%) out of the eleven patients. The lapse between the birth date and the initiation of L-thyroxine treatment in CH-positive children was lower than 15 days in 63.64% of cases or 15 to 30 days in 36.36% of children. Further research is required to expand the screening coverage for CH in Mongolia.

摘要

先天性甲状腺功能减退症(CH)是导致智力残疾的最常见病症之一,可通过新生儿筛查(NBS)进行早期检测来预防。在蒙古,2000年启动了一项针对CH的区域筛查计划,该计划得到了国际原子能机构(IAEA)亚太地区的支持。在我们目前的研究中,2012年至2020年期间,对来自乌兰巴托九个地区的23002名新生儿进行了筛查,通过测量出生后24至72小时采集的干血斑中的促甲状腺激素(TSH)水平。TSH水平通过DELFIA测定法进行测量。出生时确诊的CH总体患病率为1/2091。CH病例的男女比例为1.8:1。大多数患者无症状(CH病例的72.7%);脐疝以及皮肤发冷或出现斑纹是CH患者报告的症状(27.3%)。甲状腺发育异常(发育不全和缺如)是最常见的病因,11例患者中有9例(81.8%)。CH阳性儿童出生日期与开始左甲状腺素治疗之间的间隔时间,63.64%的病例低于15天,36.36%的儿童为15至30天。需要进一步研究以扩大蒙古CH的筛查覆盖范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b7d/8293200/3df9df0a2fb2/IJNS-07-00029-g001.jpg

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