先天性甲状腺功能减低症患儿社会生活能力及其影响因素的研究

Study of social-life ability and interference factors in infant with congenial hypothyroidism

目的:评估婴幼儿先天性甲状腺功能减低症(congenial hypothyroidism,CH)的社会生活能力及其影响因素。方法:选取经南通大学附属妇幼保健院筛查确诊且经过规范治疗的CH患儿41例及与之相配的正常同龄儿童53例作为研究对象,采用婴儿-初中生社会生活能力量表及1~3岁儿童气质评估量表对研究对象的社会生活能力及气质特征进行评估。结果:(1)两组患儿的社会生活能力分级差异无统计学意义(P>0.05),但独立生活、运动及集体活动差异均有统计学意义(均P<0.05);(2)两组儿童气质类型分布比较差异无统计学意义(P>0.05);(3)两组儿童在心境、注意分散度及反应强度3个维度比较差异均有统计学意义(均P<0.05);(4)初筛促甲状腺激素浓度、气质及家庭环境是影响CH患儿社会生活能力的重要因素。结论:CH患儿尽管在新生儿期间得到早期诊断和治疗,但其婴幼儿期的社会生活能力仍受影响,治疗时应根据其心理发育特点采取个性化的治疗方案及干预措施。

Objective:To evaluate social-life ability and its interference factors of infant with congenial hypothyroidism(CH).Methods:41 children with CH detected and treated in Affiliated Maternity and Child Health Care Hospital of Nantong University were studied and compared to 53 matched normal children born at the same time.Infant-junior middle school student’s ability of social life scale and 1-3 years child temperament questionnaire were used to evaluate the social-life ability and temperament types of these children.Results:(1)No significant difference was observed in classified scores of social competence(P>0.05),but a significant difference was observed in independent life,exercise and collective activity(P<0.05).(2)There was no significant difference in temperament type distribution between the two groups(P>0.05).(3)The difference of the mood,notice separate degree and response intension of CH infant comparing with the matched group was significant(P<0.05).(4)TSH level of neonatal screening,temperament and family environment were the significant influencing factors of CH.Conclusions:Despite early diagnosis and treatment during the neonatal period,the social life of infants with CH is still affected,so individualized treatment plan and intervention measures should be adopted according to their psychological development characteristics.