云南省部分地区先天性甲状腺功能减低症治疗效果分析

发布时间：2018-02-25 21:33

本文关键词： 先天性甲状腺功能减低症初始治疗剂量治疗时机儿童　出处：《中国当代儿科杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的观察不同初始治疗剂量和治疗时机对先天性甲状腺功能减低症(CH)的疗效影响。方法以云南省4个地区新生儿筛查提示TSH异常、最终确诊并治疗随访的98例CH患儿为研究对象,予左旋甲状腺素钠治疗,按初始治疗剂量分为标准剂量组(每日10~15μg/kg)和小剂量组(每日10μg/kg),按照治疗起始时间又分为2月龄内治疗组和2月龄后治疗组。监测治疗前及治疗后多时点的甲状腺功能以及体格和神经发育情况。结果治疗后2周,标准剂量组的TSH低于小剂量组,FT4高于小剂量组,差异有统计学意义(P0.05),治疗后其他时间点的TSH、FT4差异均无统计学意义(P0.05);两组在治疗前以及治疗后各个时间点体格和神经发育的差异无统计学意义(P0.05)。不同治疗时机组,治疗后各个不同时间点的TSH和FT4及体格发育的差异均无统计学意义(P0.05);2月龄内开始治疗的患儿在6月龄时适应性行为、大运动、精细动作能区评分,12月龄时大运动能区评分,18月龄时精细动作能区评分,以及24月龄时语言能区评分均较高,差异具有统计学意义(P0.05)。结论标准剂量组疗效优于小剂量组,但需注意治疗后甲亢表现;治疗时机对CH患儿神经发育影响大,一经确诊,应尽早开始治疗。
[Abstract]:Objective to observe the effect of different initial dosage and time of treatment on congenital hypothyroidism. Methods newborn screening in four areas of Yunnan Province revealed abnormal TSH. Ninety-eight children with Ch who were finally diagnosed and followed up were treated with levothyroxine sodium. According to the initial dose, the patients were divided into standard dose group (10 渭 g / kg daily) and small dose group (10 渭 g / kg / day). According to the initial time of treatment, they were divided into 2 month old treatment group and 2 month old treatment group. Thyroid gland was monitored before and after treatment. Function and physical and neurological development. Results 2 weeks after treatment, The TSH of the standard dose group was lower than that of the low dose group and FT4 was higher than that of the low dose group. The difference was statistically significant (P 0.05), and there was no significant difference in TSHT 4 between the two groups at other time points after treatment, and there was no significant difference in physical and nerve development between the two groups before and after treatment (P 0.05). There was no significant difference in TSH, FT4 and physical development at different time points after treatment. The fine motor energy area score at 12 months old and the fine motor energy area score at 18 months old and the language energy area score at 24 months old were higher, the difference was statistically significant (P 0.05). Conclusion the curative effect of standard dose group is better than that of small dose group. But we should pay attention to the manifestation of hyperthyroidism after treatment, the time of treatment has a great influence on the nerve development of children with Ch, once diagnosed, we should start treatment as soon as possible.
【作者单位】：云南省第一人民医院儿科;昆明理工大学附属昆华医院;云南省第一人民医院遗传诊断中心;
【基金】：云南省卫生科技计划项目(2011WS004)
【分类号】：R725.8

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