早期治疗对先天性甲状腺功能减低症患儿智力及体格发育的影响

Effects of early treatment on physical and intelligence development in children with congenital hypothyroidism

摘要:

目的：比较治疗开始时间不同的先天性甲状腺功能减低症（congenital hypothyroidism, CH）患儿治疗后智力发育、体格发育水平的不同，以寻求改善患儿预后的最佳治疗时间。方法：对2008年9月至2011年9月经新生儿疾病筛查确诊为CH，并在出生后3个月内开始应用甲状腺激素治疗的CH患儿49名,按开始治疗时间分为两组：生后1个月内治疗组（n=26）及1～3个月治疗组（n=23）。分别于6个月、1岁、2岁时，检测两组患儿体格发育情况，应用Gessell 发育量表评估智力发育商（DQ）及采用免疫荧光法测定甲状腺功能。结果：两组经甲状腺激素长期治疗，6个月、1岁、2岁时游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）及促甲状腺素（TSH）水平差异无统计学意义（P>0.05），但1个月内治疗组患儿的身长、体重均明显高于1～3个月治疗组，差异有统计学意义（P0.05）。结论：CH开始治疗时间影响患儿智力发育和体格发育；生后1个月内开始治疗者，智力及体格发育优于1～3个月开始治疗者。

Abstract:

OBJECTIVE: To compare differences in the intelligence and physical developmental levels of children with congenital hypothyroidism (CH) who received initial treatment at different times. METHODS: Forty-nine children with CH diagnosed by neonatal screening between September 2008 and September 2011 were enrolled in this study. According to the timing of initial treatment with thyroid hormone, they were classified into two groups: 0.05) at 6 months old, 1 year and 2 years old. However, heights and weights in the 0.05). CONCLUSIONS: The timing of initial treatment with thyroid hormone appears to be associated with the intelligence and physical development in children with CH. Treatment starting at less than 1 month of life contributes to improved physical and intelligence development compared with treatment starting at 1 to 3 months of life.