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新生儿查初级和中央先天性甲状腺功能低下症:是时候去荷兰了吗?
Anita Boelen1,2,3, Nitash Zwaveling-Soonawala2,4, Annemieke C Heijboer1,2,3,5
1Endocrine Laboratory, Department of Laboratory Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands.
European thyroid journal
|June 16, 2023
概括
早期发现先天性甲状腺功能低下症 (CH) 对大脑发育至关重要. 荷兰独特的查算法有效地识别了初级和中央CH,改善了患者的治疗结果.
科学领域:
- 内分泌学 在内分泌学.
- 新生儿查 新生儿查
- 发育神经科学的发展神经科学.
背景情况:
- 甲状腺激素 (TH) 对于生命早期不可逆转的大脑发育至关重要.
- 先天性甲状腺功能低下症 (CH),甲状腺缺乏,可以源于甲状腺问题 (初级CH) 或垂体/甲状腺下垂体功能障碍 (中央CH).
- 标准新生儿查 (NBS) 主要通过TSH水平检测初级CH,往往错过中央CH病例.
研究的目的:
- 通过NBS强调通过NBS检测初级和中央CH的重要性.
- 引入荷兰用于综合性CH查的独特NBS算法.
- 倡导将中央CH检测纳入全球NBS计划.
主要方法:
- 使用了一个T4-TSH-甲状腺素结合型全球蛋白 (TBG) NBS算法.
- 应用了这个算法来查新生儿的初级和中央形式的CH.
- 分析了算法在检测不同CH亚型中的有效性.
主要成果:
- T4-TSH-TBG算法成功检测了初级和中央CH.
- 有证据表明,中央CH往往是中度至重度,而不是轻度.
- 通过NBS早期发现中心CH可能会改善临床结果.
结论:
- 荷兰NBS算法可以检测初级和中央CH.
- 通过NBS检测中央CH对于改善患者护理和临床结果至关重要.
- 强烈建议将NBS扩展到包括中央CH检测.
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