28例学龄期先天性甲状腺功能减退症患儿的疗效分析

Curative effect analysis of 28 cases of schoo-age children with congenital hypothyroidism

目的分析先天性甲状腺功能减退症(CH)患儿的长期疗效,为完善治疗方案提供依据。方法以佛山市妇幼保健院筛查、确诊并长期治疗的CH患儿为研究对象,根据纳入、排除标准纳入28例CH患儿。检测患儿血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平,测量并评估患儿生长发育及智力发育水平,并与相应的正常水平进行对比分析。结果经治疗28例患儿首次复查TSH转至正常20例(71.4%),末次复查TSH正常22例(78.6%);除1例患儿末次复查体质量低于正常范围,其余患儿出生时及末次复查时身长(高)、体质量均处于正常范围;25例(89.3%)患儿智力发育达到或接近平常水平,3例(10.7%)患儿处于智力低下的边界或轻度智力低下。结论早期诊断、系统治疗对CH患儿的远期疗效及预后起着重要作用,应该加强CH患儿的系统管理,尽早控制TSH水平,提高患儿的就诊依从性。

Objective To analyze the long-term efficacy of children with congenital hypothyroidism（CH）to provide the basis for perfecting the treatment scheme.Methods 28 cases of CH screened,diagnosed and treated for long term in Foshan Municipal Maternal and Child Health Care Hospital were included in this study according to the inclusion and exclusion standards.Serum TSH,FT3 and FT4levels were detected,the growth,physical development and intelligence development situation were measured,evaluated and performed the comparative analysis with the corresponding normal levels.Results Among 28 cases,the TSH level at the first re-examination in 20cases（71.4%）conversed to the normal level,which at last re-examination in 22cases（78.6%）conversed to the normal level;except the body mass at last re-examination in 1case was lower than the normal range,the body height and body mass at birth and last re-examination in other cases all were in the normal ranges;the intelligence development in 25cases（89.3%）reached or closed to the normal level,3cases were in the boundary of mental retardation or slight mental retardation.Conclusion Early diagnosis and systematical treatment could play an important role in the long-term efficacy and prognosis of CH children.The systematical management of CH children should be strengthened and the visiting compliance should be increased.