某三级医院新生儿病房新生儿甲状腺状况筛查

Shaheda S. Ahmed, Wazir Ahmed, M. J. Uddin, Feroza Aktar, S. Dutta, Ziaur Rahman, A. Hoque
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Screening at the proper time (Approximately 2-7 days after birth), rechecking of suspicious cases within a week, and initiation of treatment (Within 2 weeks of age) of thyroid disorders particularly Congenital Hypothyroidism (CH), can prevent the irreversible mental and physical impairments. Transient neonatal hyperthyroidism is the common form of neonatal hyperthyroidism. The purpose of the study was, Neonatal Screening (NS) to evaluate the rate of thyroid disorders among Preterm (Early preterm born before 34th week of gestation, late preterm born between 34th week and before 37th week of gestation), Term (Born within 37th to 42nd week of gestation) and Post-term (Born after 42nd week of gestation) newborns. Birth weight was alsomeasured to categorize the newborns according to their weight. \nMaterials and methods: It was a cross-sectional, observational type of study. The place was the Neonatal Department of Chattogram Maa-O-Shishu Hospital Medical College, Chattogram. 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引用次数: 0

摘要

背景:新生儿筛查方案是非常富有成效的拯救我们的新生儿从可预防的新生儿疾病,从而健康培养后代。虽然新生儿甲状腺疾病筛查是预防性儿科最伟大的成功之一,但在孟加拉国的国家一级,实际上并没有对所有新生儿进行筛查。大多数患有甲状腺疾病的新生儿外观正常,没有可检测到的体征,几乎总是被遗漏。适时筛查(出生后约2-7天),一周内复查可疑病例,对甲状腺疾病特别是先天性甲状腺功能减退(CH)开始治疗(2周内),可预防不可逆转的精神和身体损害。短暂性新生儿甲状腺功能亢进是新生儿甲状腺功能亢进的常见形式。本研究的目的是,新生儿筛查(NS)评估早产儿(妊娠34周前的早期早产儿、妊娠34周至37周前的晚期早产儿)、足月新生儿(妊娠37周至42周内出生)和足月新生儿(妊娠42周后出生)甲状腺疾病的发生率。出生体重也被确定,以根据新生儿的体重进行分类。材料和方法:本研究为横断面观察型研究。地点是Chattogram Maa-O-Shishu医院医学院新生儿部。采集80例2 ~ 7天新生儿的血样,送至实验室测定TSH和FT4。结果:样品总数为80份。其中早产新生儿19例,足月新生儿61例,未发现足月后病例。两组再次分为正常出生体重组(2.5 kg)和低出生体重组(< 2.5 kg)。足月新生儿甲状腺功能亢进(FT4高或正常,TSH低)23例(37.7%),甲状腺功能减退(FT4低或正常,TSH高)11例(18.03%),其余为甲状腺功能正常(TSH正常,FT4正常/增高/降低)。在早产病例中,甲状腺功能低下03(15.78%)多于甲状腺功能亢进02(10.52%)。结论:我们的研究发现,在入院的新生儿中,约有一半(80人中有39人)甲状腺功能异常。甲状腺功能异常的新生儿通知其父母,由内分泌科进行进一步评估。这将有助于最终的诊断和治疗。上海医科大学医学院;月,(2);2022年7月;页面44-47
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Screening of New-Borns for Thyroid Status Admitted in Neonatal Ward of a Tertiary Care Hospital
Background: Neonatal screening program is very fruitful in saving our newborns from preventable neonatal diseases, thereby healthy grooming of future generations. Though newborn screening for a thyroid disorder is one of the greatest successes in preventive pediatrics but still has not practically worked out for all neonates in Bangladesh at the national level.The majority of newborns with a thyroid disorder have a normal appearance without detectable physical signs and are almost always missed. Screening at the proper time (Approximately 2-7 days after birth), rechecking of suspicious cases within a week, and initiation of treatment (Within 2 weeks of age) of thyroid disorders particularly Congenital Hypothyroidism (CH), can prevent the irreversible mental and physical impairments. Transient neonatal hyperthyroidism is the common form of neonatal hyperthyroidism. The purpose of the study was, Neonatal Screening (NS) to evaluate the rate of thyroid disorders among Preterm (Early preterm born before 34th week of gestation, late preterm born between 34th week and before 37th week of gestation), Term (Born within 37th to 42nd week of gestation) and Post-term (Born after 42nd week of gestation) newborns. Birth weight was alsomeasured to categorize the newborns according to their weight. Materials and methods: It was a cross-sectional, observational type of study. The place was the Neonatal Department of Chattogram Maa-O-Shishu Hospital Medical College, Chattogram. Blood samples were collected from eighty neonates aging 2 to 7 days and sent to the laboratory for estimation of TSH and FT4. Results: Total number of samples was 80. Out of them, preterm new-born were 19 and term new-born were 61, no post-term case was found. Both groups wereagain divided into normal birth weight (³2.5 kg) and low birth weight (< 2.5 kg). Hyperthyroidism (High or normal FT4 but low TSH) was observed in 23 term newborns (37.7%) and hypothyroidism (Low or normal FT4 but high TSH) in 11 term newborns (18.03%) and the rest were Euthyroid (TSH normal, FT4 normal/increased/decreased). In the case of preterm, there were more hypothyroid 03 (15.78%) than hyperthyroid 02(10.52%). Conclusion: Our study observed that, among the newborns, who were admitted to the hospital,around half of them (39 out of 80) had abnormal thyroid function. The newborns with abnormal thyroid status were informed to their parents for further evaluation by the Department of Endocrinology. It would be helpful to reach the final diagnosis and treat it accordingly. Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 44-47
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