珠海地区重型β-地中海贫血儿童甲减发生率及危险因素的分析

Prevalence Rate and Risk Factors of Hypothyroidism in Children with Beta Thalassemia Major in Zhuhai Area

目的:分析珠海地区重型β-地中海贫血(β-thalassemia major,β-TM)儿童甲状腺功能减退的发生率及危险因素。方法:对2018年8月至2020年8月在中山大学附属第五医院儿科和珠海市妇幼保健院儿科就诊并长期随访的86例β-TM患儿进行临床特征分析,了解珠海地区β-TM患儿甲状腺功能减退发生率,分析影响甲减发生率的危险因素。结果:珠海地区β-TM患儿甲状腺功能减退发生率为17.4%,甲状腺功能减退患儿血清铁蛋白均值(4948.27±1225.33μg/L)明显升高(t=10.273,P<0.05)。年龄≥10岁、血清铁蛋白≥2 500μg/L和未进行规范去铁治疗的β-TM患儿甲减发生率均明显升高(P<0.05)。进一步Logistic回归分析结果显示,年龄≥10岁是甲减发生率升高的独立危险因素。不规范去铁组患儿有较高的血清铁蛋白(3880.60±1269.17μg/L)、TSH(4.43±1.52mIU/L)和甲减发生率(37.14%)(P<0.05)。结论:珠海地区β-TM患儿甲状腺功能减退发生率偏高,且与年龄≥10岁、血清铁蛋白≥2 500μg/L和未进行规范去铁治疗相关。

Objective: To investigate the prevalence rate of hypothyroidism in children with β-thalassemia major( β-TM) and its risk factors. Methods: A total of 86 children with β-TM treated and followed up in the Department of Pediatrics of the Fifth Affiliated Hospital of Sun Yat-Sen University,Zhuhai Municipal Maternal and Child Health Care Hospital from August 2018 to August 2020 were enrolled. The clinical data of the children were analyzed to investigate the prevalence rate of hypothyroidism in children with β-thalassemia major( β-TM) and its risk factors. Results: The prevalence rate of hypothyroidism in children with β-TM in Zhuhai area was 17.4%. The level of serum ferritin( SF)( 4948.27±1225.33 μg/L) in hypothyroidism children was significantly increased( t = 10.273,P<0.05). The prevalence rate of hypothyroidism was significantly higher in β-TM children( age ≥10 years old,SF ≥2 500 μg/L and irregular iron removal)( P< 0. 05). Logistic regression result showed that age ≥10 years old was the independent risk factor affecting the increasing of hypothyroidism rate in the children. The levels of SF( 3880.60±1269.17 μg/L),TSH( 4.43±1.52 mIU/L) and the prevalence rate of hypothyroidism( 37.14%)( P<0.05) were higher for the children in irregular iron removal group. Conclusion: The prevalence rate of hypothyroidism in children with β-TM in Zhuhai area is high,and it is related to the age ≥10 years old,SF ≥2 500 μg/L and irregular iron removal of the children.