摘要
目的:探讨婴儿先天性甲状腺功能减退症(CH)的治疗方法及预后。方法:选取松滋市人民医院2016年3月-2019年6月收治的确诊为CH的114例患儿纳入研究。根据左旋甲状腺素钠治疗时间不同分为对照组和观察组,每组57例。对照组患儿采用左旋甲状腺素钠治疗1年,停药1个月后检测促甲状腺激素(TSH),激素水平有服药指征继续服药,激素水平正常后停止用药。观察组患儿根据TSH水平变化动态调节左旋甲状腺素钠剂量,且治疗时间延长至患儿2岁。比较两组患儿在半岁、1岁及2岁的甲状腺功能和体格、智力发育情况。结果:半岁、1岁时,两组患儿TSH、游离三碘甲腺原氨酸(FT)及游离甲状腺素(FT)比较,差异均无统计学意义(P>0.05);2岁时,观察组患儿的TSH低于对照组,FT、FT均高于对照组,差异均有统计学意义(P<0.05)。半岁、1岁时,两组患儿低体重、矮身材发生率比较,差异均无统计学意义(P>0.05);2岁时,观察组低体重、矮身材发生率均为1.75%,低于对照组的14.04%和15.79%,差异均有统计学意义(P<0.05)。1、2岁时,两组平均发育商、大运动、精细运动、适应能力、语言及社交行为评分均优于半岁时,差异均有统计学意义(P<0.05);观察组患儿2岁时的平均发育商、大运动、精细运动、适应能力、语言及社交行为评分均高于对照组,差异均有统计学意义(P<0.05)。结论:CH患儿采用左旋甲状腺素钠片个性化治疗至2岁,可以有效改善患儿的甲状腺功能,并改善患儿因先天性甲状腺功能不全导致的体格及智力方面的发育情况,适合在临床上推广应用。
Objective:To explore the treatment and prognosis of congenital hypothyroidism(CH)in infants.Method:A total of 114 children diagnosed with CH admitted to Songzi People’s Hospital from March 2016 to June 2019 were included in this study.According to the different treatment time of Levothyroxine Sodium,they were divided into control group and observation group,57 cases in each group.The children in the control group were treated with Levothyroxine Sodium for 1 year,and thyroid stimulating hormone(TSH)was detected one month after the drug was stopped,the hormone level was indicated to take medication,and the drug was stopped when the hormone level was normal.In the observation group,the dose of Levothyroxine Sodium was adjusted dynamically according to the change of TSH level,and the treatment time was extended to 2 years old.The thyroid function,physical and mental development were compared between the two groups at the age of six months,one year and two years.Result:There were no significant differences in TSH,FTand FTbetween the two groups at the age of 6 months and 1 year(P>0.05);at 2 years old,the TSH of the observation group was lower than that of the control group,and the FTand FTof the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).At the age of 6 months and 1 year,there were no significant differences in the incidences of low weight and short stature between the two groups(P>0.05);at 2 years old,the incidences of low weight and short stature in the observation group were 1.75%,which were lower than 14.04%and 15.79%in the control group,the differences were statistically significant(P<0.05).At 1 and 2 years old,the average developmental quotient,gross motor,fine motor,adaptive ability,language and social behavior scores of the two groups were better than those at 6 months old,the differences were statistically significant(P<0.05);the average developmental quotient,gross motor,fine motor,adaptive ability,language and social behavior scores of the observation group at 2 years old were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Personalized treatment with Levothyroxine Sodium Tablets can effectively improve the thyroid function of children with CH until the age of 2 years,and improve the physical and mental development of children due to congenital thyroid insufficiency,which is suitable for clinical application.
作者
张莉
李丹
粟显文
裴成
ZHANG Li;LI Dan;SU Xianwen;PEI Cheng(Songzi People’s Hospital,Hubei Province,Songzi 434200,China)
出处
《中国医学创新》
CAS
2022年第33期122-126,共5页
Medical Innovation of China
