The Clinical Analysis Of The Early Diagnostic Factors Of The Neonatal Congenital Adrenal Hyperplasia

Objective：Analyse the clinical signs, clinical manifestation, auxiliaryexaminations and the prognosis of the neonates who were preliminaryconsidered to be diagnosed with Congenital adrenal hyperplasia, andsummarize the significance of those factors in the diagnosis of the congenitaladrenal hyperplasia. In order to improve the detection rate、early diagnosisrate and give active intervention treatment to the Congenital adrenalhyperplasia neonate.Methods：Collect the clinical data of the90neonates in Neonatal Wardof the Children’s Hospital of Chongqing medical university from November2002to December2012，who were preliminary diagnosed with Congenitaladrenal hyperplasia because of having skin pigmentation. Choose51neonates whose data were integrated. Divide these neonates into two groupsaccording to whether making a definite diagnosis when they weredischarged, and carries on the correlation analysis between groups. Andmake clinical analysis of the10definite diagnosed cases.Results：10definite diagnosed cases had skin pigmentation.5cases had abnormal genital malformation, and one of them was false judged on thesex.3cases were hairiness.10cases had electrolyte disorder and abnormalresults of the specific laboratory examination.2cases had hypoglycemia.2cases had abnormal adrenal images. There were significant differences inthe rate of the areolar pigmentation and the genital malformation of the twogroups(P<0.05). The weight loss rate is also significant different in the twogroups(P<0.05). The rate of the hyponatremia and hypokalaemia of thedefinite diagnosed group is higher than the undetermined diagnosedgroup(P<0.05),and there was no significant difference in the rate of thehypokalemia and metabolic acidosis of the two groups(P＞0.05). Theaverage level of the17-hydroxyprogesterone, ACTH, testosterone of the thedefinite diagnosed group is higher than the undetermined diagnosedgroup(P<0.05).Conclusions：The incidence of neonatal classical CAH in the childrenwith skin pigmentation is higher than that of the world, and the areolapigmentation has great significance on the diagnosis of the CAH. Theclassical patients with serious genital malformation could be false judgedon the sex. In clinical manifestation， the weight loss had greatersignificance than the other symptoms. The hyponatremia and hypokalaemiahad great contributions to the diagnosis of the classical CAH neonates, andthe specifity of the hypokalemia and metabolic acidosis in the diagonosiswas low. The level of17-OHP, ACTH,and testosterone made the decisive role in the diagnosis of the CAH. The positive rate of adrenal imagingexamination in the diagnosis of CAH was about50%.