左甲状腺素钠片不同初始剂量治疗先天性甲减的疗效分析

Clinical efficacy analysis of left thyroxine sodium tablets in the treatment of congenital hypothyroidism with different initial doses

目的探讨左甲状腺素钠片采用不同初始剂量替代治疗先天性甲状腺功能减退症临床疗效,以确定较佳的初始剂量为临床治疗提供依据。方法选取某院2015年2月至2017年6月收治住院治疗先天性甲状腺功能减退症患儿90例,按照随机对照原则分为治疗组和对照组,每组各45例,两组患儿均采用左甲状腺素钠片治疗,治疗组给予8μg/(kg·d)初始剂量治疗,而对照组给予12μg/(kg·d)初始剂量治疗;观察两组患儿治疗前后血清甲状腺激素水平变化情况、采用GESELL智力发育筛查量表评估智力行为发育情况及不良反应发生率。结果两组治疗前甲状腺激素各项指标差异无统计学意义(P>0.05),治疗后甲状腺激素各项指标均较治疗前有所改善,但治疗组优于对照组,差异有统计学意义(P<0.05);两组在智力行为发育情况比较差异无统计学意义(P>0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论左甲状腺素钠片替代治疗先天性甲状腺功能减退症临床疗效确切,可以有效改善患儿甲状腺功能,保证了正常的智力行为发育,且初始剂量应用8μg/(kg·d)是较为理想的剂量。

Objective To investigate the clinical efficacy of left thyroxine sodium tablets in the treatment of congenital hypothyroidism with different initial doses to determine the optimal initial dose for clinical treatment.Methods 90 children of congenital hypothyroidism admitted in a hospital from February 2015 to June 2017 were randomly divided into the treatment group and the control group according to the order of treatment,with 45 patients in each group.The patients in the treatment group were treated with left thyroxine sodium tablets with the initial dose of 8μg/(kg·d)while the control group was given the initial dose of 12μg/(kg·d).The changes of serum thyroid hormone levels of the two groups were observed before and after the treatment.The GESELL Intelligence Development Screening Scale was adopted to assess the development of intelligence behavior and the incidence of adverse reactions.Results Before treatment,the thyroid hormone indexes difference between the two groups was not statistically significant(P>0.05).After treatment,the thyroid hormone indexes improved compared with those before treatment.The improvement of treatment group was better than that of the control group and the difference was statistically significant(P<0.05).There was no significant difference between the two groups in the development of intelligence behavior(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Left thyroxine sodium tablets in the treatment of congenital hypothyroidism can improve the thyroid function in children and ensure the normal development of their mental behavior.The initial dose of 8μg/(kg·d)is the ideal dose.