先天性甲状腺功能减低症治疗时机的疗效评估

Evaluation on treatment and prognosis of congenital hypothyroidism at various ages

目的探讨小儿先天性甲状腺功能减低症(以下简称先天性甲低)治疗时机评估及其与预后情况。方法对1998年5月至2008年12月在广东省深圳市人民医院儿科内分泌专科门诊就诊的68例治疗随访时间超过2年的先天性甲低患儿的体格检查和智能测定进行分析,以评估不同治疗时机对其预后的影响。筛查组47例,开始治疗年龄13～59d;非筛查组21例,开始治疗年龄6个月至14岁。结果先天性甲低患儿的身高、体重与智能发育筛查组与非筛查组比较差异有统计学意义(P均<0.01),遗留智能残疾的发生率两组比较差异亦有统计学意义(P<0.01)。结论对先天性甲低患儿实施治疗的时间越早,智能发育和体格发育越好,遗留智能残疾的发生率越低。

Objective To evaluate the treatment and prognosis of congenital hypothyroidism at various ages. Methods From May 1998 to December 2008, sixty-eight cases of congenital hypothyroidism in The Second Clinical Medical College of Jinan University, Shenzhen People＇s Hospital, were followed up for more than 2 years during the period of treatment; intelligence and physical development were investigated.The cases were divided into 2 groups： screened group and non-screened group. The cases in screened group accepted treatment from age of 13 days to 59 days ; for those in non-screened group, treatment started from age of 6 months to 14 years old. Results The intellectual developments and physical improvement in the screened group were significantly better than those of the non-screened group （P 〈 0.01 ）.The paralysed rates of children with congenital hypothyroidism in the screened group were significantly lower than those of the non-screened group （Fisher＇ s Exact Test , P 〈 0.01 ）.Conclusion The intellectual development and physical improvement in the screened group are significantly better than those of the non-screened group. The paralysed rates of children with congenital hypothyroidism can be decreased by early screening and treatment.