不同初始治疗时机对先天性甲状腺功能减退症患儿的治疗效果分析

The efficacies of different initial treatment timing on congenital hypothyroidism in children

目的比较不同初始治疗时机对先天性甲状腺功能减退症(CH)患儿体格与智力发育的影响。方法以经新生儿疾病筛查确诊为CH且体格、智力评估资料完善的84例患儿为研究对象,根据不同初始治疗时机分为1月内治疗组(38例)与1～3月治疗组(46例)。分别比较两组患儿在6、12、24月3个时间点的甲状腺功能及体格、智力发育情况。结果经长期治疗后,两组患儿在6、12、24月3个月龄的促甲状腺激素、游离甲状腺素及身高、体重差异均无统计学意义(P>0.05)。此外,两组患儿在6月龄、24月龄时的5个能区评分差异也无统计学意义(P>0.05),仅在12月龄时的社交行为能区评分差异有统计学意义(P<0.05)。结论不同初始治疗时机对CH患儿的神经发育有一定影响,因此,患儿一旦确诊,应尽早治疗。

Objective To compare the effacies of different initial treatment timing on physical and mental development of children with congenital hypothyroidism(CH). Methods Eighty-four children with congenital hypothyroidism(CH) diagnosed by neonatal disease screening from October 2014 to October 2016 and with complete physical and intellectual data were enrolled in the study. According to the different initial treatment timing, they were classified into treatment group within 1 month(38 cases) and treatment group from 1 to 3 months(46 cases). The thyroid function, physical development levels and neural development were compared at 6 months, 12 months and 24 months old. Results After long-term treatment, there was no significant difference in thyroid stimulating hormone(TSH), free thyroxine(FT4), height or weight between the two groups at 6 months, 12 months, and 24 months old(P>0.05). In addition, there was no significant difference in intelligence scores between the two groups at 6 months and 24 months old(P>0.05). There was a statistically significant difference only in social behavioral scores at 12 months old(P<0.05). Conclusion Different initial treatment timing has a certain influence on the neurodevelopment of children with CH. Therefore, once the child was diagnosed, it should be treated as soon as possible.