摘要
目的 探讨不同剂量左甲状腺素治疗先天性甲状腺功能减低症(congenital hypothyroidism,CH)的临床疗效,以寻找最佳治疗剂量.方法 选择CH 60例,随机分为低剂量组和常规剂量组各30例,均应用左甲状腺素治疗.常规剂量组起始剂量10 ~ 15 μg/(kg·d),维持剂量80 ~ 100 μg/d;低剂量组起始剂量8~10μg/(kg·d),维持剂量50~ 80 μg/d.观察两组治疗2个月时甲状腺功能指标及治疗至2岁时智力情况.结果 治疗2个月时,两组FT3和FT4差异无统计学意义(P>0.05);低剂量组TSH值(2.6±1.2) mU/L明显低于常规剂量组(11.3±8.2) mU/L,差异有统计学意义(P<0.01).2岁时参照儿童韦氏智力测试量表(C-WYCSI)检测患儿操作智商(PIQ)、语言智商(VIQ)和总智商(FIQ)的变化情况,低剂量组各项指标均高于常规剂量组,差异有统计学意义(P<0.01).结论 应用低剂量左甲状腺素治疗CH有助于改善患儿的甲状腺功能和智力水平,推荐剂量为起始剂量8~10μg/(kg·d),维持剂量50~ 80 μg/d.
Objective To investigate the clinical efficacy of different doses levothyroxine in treatment of congenital hypothyroidism (CH) to find the optimal therapeutic dosage. Methods A total of 60 patients with CH were randomly divided into low-dose group (n = 30) and routine dose group (n = 30) , and all patients received levothyroxine treatment. The routine dose group was treated with 10-15 μg/( kg · d) of initial dose and 80-100 μg/d of maintenance dose; the low-dose group was treated with 8-10 μg/(kg · d) of starting dose and 50-80 μg/d of maintenance dose. The thyreoid functional parameters in two groups were observed after treatment for 2 months, and intelligence status was also observed in patients who received con- tinued treatment at the age of two. Results After treatment for 2 months, the differences of values of FT3 and FT4 in two groups were not statistically significant ( P 〉 0.05 ) ; TSH value of (2.6 ± 1.2) mU/L in low-dose group was significantly lower than that of (11.3 ±8.2) mU/L in routine dose group, and the differences were statistically significant ( P 〈0. 01 ). The changes of performance intelligence quotient (PIQ) , verbal intelligence (VIQ) and full-scale intelligence quotient (FIQ) were detected by Wechsler intelligence scale (C-WYCSI) when patients were two years old. The indexes in low dose group were significantly higher than those in routine dosage group, and the differences were statistically significant ( P 〈 0.01 ). Conclusion Low dose of levothyroxine in treatment of congenital hypothyroidism may improve thyroid function and intelli- gence level, and the recommended doses are 8-10 μg/d of initial dose and 50-80 μg/d of maintenance dose.
出处
《临床误诊误治》
2013年第10期68-70,共3页
Clinical Misdiagnosis & Mistherapy