摘要
目的探讨先天性甲状腺功能减退症(CH)患儿甲状腺形态学改变、开始治疗时间及治疗前甲状腺功能(血FT_4、TSH浓度)对患儿智力发育的影响。方法对52例CH患儿确诊后即给予左旋甲状腺素口服,监测其智力、体格发育,并进行甲状腺核素扫描(^(99m)TcO_4)或(和)超声检查了解甲状腺形态学改变,10～30个月行Bayley婴儿发育测量法测试,得到智力发育指数(MDI)及运动发育指数(PDI)测试结果,根据治疗开始时间及形态学改变进行分组分析。结果甲状腺形态学异常组MDI明显低于甲状腺形态正常组(91±20 vs 102±15,P<0.05),患者越晚开始治疗对MDI影响越大,以61～90 d治疗者MDI(73±24)影响最为显著。结论CH患儿智力发育与甲状腺形态学改变及开始治疗时间有关,提示对筛查检出的新生儿甲减早期诊断和治疗的重要性。
Objective To explore the effect of the thyroid morphologic change, the initiating treatment time and the thyroid function （ serum FT4 ,TSH） on mental development in children with congenital hypothyroidism （CH）. Methods After diagnosed, 52 cases of CH were orally administrated with L-T4, then their mental and physical development were monitored and thyroid morphologic changes were observed by thyroid imaging （ ^99mTcO4 ） and type B ultrasonography. The Bayley test was performed at the age of 10 to 30 months and expressed as mental developmental index （MDI） and psychomotor developmental index （PDI）. Analysis was conducted upon treatment timing and thyroid morphologic changes. Results The MDI in those cases with morphologic abnormalities treated within 90 days was significantly lower than that with normal morphology （91 ± 20 vs 105 ± 15, P 〈 0.05）. Moreover, the later the treatment is, the lower the MDI is in CH patients, especially in those treated within 61 to 90 days MDI being the lowest. Conclusion The mental, development of children with CH was related to thyroid morphologic change, function and initiation of thyroid hormone replacement, suggesting the importance of early diagnosis and treatment for CH patient.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2007年第6期498-500,共3页
Chinese Journal of Endocrinology and Metabolism
基金
上海市重点学科(T0204)
