不同补碘时期可疑亚临床克汀病儿童甲状腺激素水平变化

Change of suspicious sub-cretin children's serum T3, T4, TSH in different period of iodine supplementation in iodine deficiency region

目的 检验不同补碘时期,激素性甲状腺功能低下对亚临床克汀病(亚克汀病)诊断的有效性。方法 从1996年至1999年,对秦巴山区3个缺碘地区的可疑亚克汀儿童与正常儿童的血清T3、T4、TSH进行测定。结果 ①当该地区处于补碘不稳定时期(1996),在缺碘时期出生的可疑亚克汀病儿童T3、T4均值与正常儿童差异无统计学意义,,TSH高值率却显著高于正常儿童(P<0.05);②当该地区补碘正常时期(1999),可疑亚克汀病儿童与正常儿童的T3、T4均值以及TSH高值率差异无统计学意义(P>0.05)。结论 激素性甲状腺功能低下与近期摄碘量不足有关,在儿童机体碘营养状况已趋于正常状况下,不宜用其辅助诊断亚克汀病患儿。

Objective To test the validity of hypothyroidism in diagnosing the sub-cretin children in different period of iodine supplementation. Methods Survey the serum T3, T4, TSH of suspicious sub cretin children and normal children in Qinba mountain area from 1996 to 1999. Results In 1996, when the supplementation of iodine was unstable in this area, the mean value of T3, T4 had no significant difference between sub-cretin children and normal children who were born in iodine deficiency period, but the TSH high-value rate of sub-cretin children was significantly higher than normal children (P < 0.05). In 1999,when the supplementation of iodine was nonnal in this area, the T3, T4, TSH level had no significant difference (P > 0.05) between the two groups. Conclusions Hypothyroidism is associated with recently iodine deficiency. When children's iodine nutrition changed to normal, it should not use hypothyroidism to diagnose the sub-cretin children.