新生儿部分高促甲状腺素血症的自然转归及治疗时机的临床研究

Research of clinical outcome and timing of treatment in neonates with partial hyperthyrotropinemia

目的探讨高促甲状腺素（TSH）血症患儿的治疗、转归及其影响因素,为临床治疗、随访提供参考依据。方法 2012-2014年两年在本院诊断为高TSH血症的新生儿,第一次复查甲状腺功能显示TSH≥15mU/L者进行药物治疗,TSH（6.27~15mU/L）者不服药为随访组,以10为切值将随访组分成两组进行随访。结果两组高TSH血症患儿的智能、身长发育差异无统计学意义,两组的自然转归结果差异亦无统计学意义,随访组中约80%高TSH血症患儿甲状腺功能在半岁以内可恢复正常。结论 1）TSH〈15mU/L的高TSH血症患儿其甲状腺功能约84.9%可自行正常恢复。2）对于10mU/L≤TSH〈15mU/L高TSH血症患儿选择治疗时应综合考虑。

Objective To investigate the treatment,outcome and influencing factors of neonatal hyperthyrotropinemia and improve the treatment and follow-up level of hyperthyrotropinemia. Methods Neonates were diagnosed hyperthyrotropinemia in 2012~2014.Some were treated with drug whose concentration of thyrotropin were greater than 15mU/L.The others were followed up whose concentration of thyrotropin were 6.27~15mU/L.The follow-up group were splited into two groups with a tangent of 10. Results Two follow-up groups with hyperthyrotropinemia had no significant differences in intelligence,length and natural outcome.The thyroid function of about 80% neonates with hyperthyrotropinemia returned to normal within 6months. Conclusions 1）84.9% neonates are back to normal on their own whose concentration of thyrotropin are less than 15 mU/L.2）Treatment for neonates should be considered comprehensively whose concentration of thyrotropin are 10~15mU/L.