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通过在滤纸上同时测定T4和TSH进行新生儿甲状腺功能减退症筛查(作者译)

[Neonatal screening for hypothyroidism by simultaneous determination of T4 and TSH on filter paper (author's transl)].

作者信息

Rochiccioli P, Dutau G

出版信息

Ann Endocrinol (Paris). 1979 Jul-Aug;40(4):455-60.

PMID:518030
Abstract

A simultaneous determination of T4 and TSH has been done on 48 000 new borns since January 1st of 1977 in the Midi-Pyrénées district. 15 cases of hypothyroidism have been detected, an incidence of 1/3 200 new borns. TSH values always were above 80 microU/ml; T4 values are under m-2 sigma in 11 cases, normal in 2 cases (8,8 and 9 micrograms/dl) and between -1 and - 2 sigma in 2 cases. A thyroid scanning with 123 odine or 99 Tech, has shown the absence of thyroid in 6 cases, an ectopic gland in 7 cases and a thyroid in a normal position in one case. A treatment has been possible before the first month of life in each case. The average D.Q. for the seven oldest new borns (m = 11 months) is 96. The simultaneous determination of T4 and TSH is a sensitive and specific screening method for hypothyroidism. False-negative are avoided and the number of false-positive results is reduced. All cases of hypothyroidism can be detected (primary hypothyroidism, hypothalamo-hypopituitary hypothyroidism, TBG deficiency, etc...) Then, an early and certain diagnosis is made possible (T4 low and TSH increased).

摘要

自1977年1月1日起,在法国南部-比利牛斯大区对48000名新生儿进行了T4和促甲状腺激素(TSH)的同步检测。共检测出15例甲状腺功能减退症,发病率为1/3200新生儿。TSH值均高于80微单位/毫升;11例T4值低于均值减2倍标准差,2例正常(分别为8.8和9微克/分升),2例在均值减1至减2倍标准差之间。用123碘或99锝进行的甲状腺扫描显示,6例甲状腺缺如,7例为异位甲状腺,1例甲状腺位置正常。所有病例均在出生后第一个月内得到了治疗。7名年龄最大的新生儿(平均年龄11个月)的平均发育商为96。T4和TSH的同步检测是一种用于筛查甲状腺功能减退症的敏感且特异的方法。避免了假阴性结果,减少了假阳性结果的数量。所有甲状腺功能减退症病例(原发性甲状腺功能减退症、下丘脑-垂体性甲状腺功能减退症、甲状腺结合球蛋白缺乏症等)均可被检测出来。这样就能做出早期且确定的诊断(T4降低且TSH升高)。

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