亚临床甲状腺功能减退症对患儿骨龄和身高的影响

Influence of Subclinical Hypothyroidism on Bone Age and Body Height in Children

目的观察亚临床甲状腺功能减退症(甲减)对儿童骨龄(BA)、身高及甲状腺激素水平的影响。方法选取30例亚临床甲减患儿为亚临床甲减组,30例体检健康儿童为健康对照组。对每位研究对象采用同一磅秤标准,测量其身高、体质量。采用Greulich-Pyle图谱法对各组儿童左手腕指关节正位片进行BA水平的评定;采用罗氏化学发光免疫分析仪E170检测各组儿童促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)水平。采用SPSS 17.0软件比较2组儿童BA、身高、TSH、FT3及FT4的差异;BA与身高、TSH、FT3及FT4间进行Pearson相关分析。结果亚临床甲减组儿童的BA[(8.17±2.29)岁]、身高[(131.47±13.41)cm]水平均落后于健康对照组[(10.08±2.75)岁、(141.05±15.12)cm](t=2.92、2.60,Pa<0.05);TSH水平[(5.93±1.77)mIU·L-1]显著高于健康对照组[(2.66±1.28)mIU·L-1](t=8.17,P<0.001)。亚临床甲减组儿童的BA与身高呈显著正相关(r=0.940,P<0.01);BA与TSH呈显著负相关(r=-0.450,P<0.05)。亚临床甲减组FT3[(5.43±1.37)pmol·L-1]、FT4[(17.29±2.03)pmol·L-1]与健康对照组[(5.83±1.11)pmol·L-1、(17.22±1.96)pmol·L-1]比较差异均无统计学意义(t=1.24、0.14,P>0.05)。结论儿童亚临床甲减可引起BA、身高的落后,需要用药物进行干预治疗。

Objective To observe the effects of subclinical hypothyroidism on bone age（BA）,body height and thyroid hormones in children.Methods Thirty children with subclinical hypothyroidism（subclinical hypothyroidism group） were recruited in the study.Meanwhile 30 healthy children were selected as healthy control group.The weight and height of each child were measured with the same platform scale.Greulich-Pyle atlas was used to evaluate the level of BA of posteroanterior radiograph about left wrist and finger joint.The levels of thyroid-stimulating hormone（TSH）,free triiodothyronine（FT3） and free-thyroxine（FT4） were measured by using the Roche chemiluminescence immunity analyzer E170.SPSS 17.0 software was used to analyze the datas.BA,body height and thyroid hormones levels were analyzed with Pearson correlation analysis.Results The BA[（8.17±2.29） years],body height [（131.47±13.41） cm] in subclinical hypothyroi-dism group were significantly lower than those in healthy control group[（10.08±2.75） years,（141.05±15.12） cm]（t=2.92,2.60,Pa0.05）.The TSH[（5.93±1.77） mIU·L-1] in subclinical hypothyroidism group was significantly higher than that in the healthy control group[（2.66±1.28） mIU·L-1]（t =8.17,P0.001）.There were statistically positive correlation between BA and body height（r=0.940,P0.01）,and negatively correlated to TSH（r=-0.450,P0.05） in subclinical hypothyroidism group.FT3[（5.43±1.37） pmol·L-1] and FT4[（17.29±2.03） pmol·L-1] in the subclinical hypothyroidism group had no statistical difference compared with those in healthy control group[（5.83±1.11） pmol·L-1,（17.22±1.96） pmol·L-1 ]（t=1.24,0.14,Pa0.05）.Conclusions Subclinical hypothyroidism in children may lead to the backward of BA and body height,and needs to be used the medicine to carry on the intervention treatment.