不同治疗时机对先天性甲状腺功能减退症患儿体格、智力及神经系统发育的影响

Effects of Different Treatment Times on Physical Build,Intelligence and Nervous System Development of Children with Congenital Hypothyroidism

目的探讨不同治疗时机对先天性甲状腺功能减退症患儿体格、智力及神经系统发育的影响。方法选取2014年6月—2018年6月在本院就诊的97例先天性甲状腺功能减退症患儿,根据治疗时机的不同分为早期治疗组(出生2个月内发现并治疗)46例和晚期治疗组(出生2个月后发现并治疗)51例。比较治疗结束后2组患儿体格发育情况;2组患儿0.5、1、2岁时促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、发育商(DQ)及神经系统发育情况。结果2组患儿0.5、1、2岁时TSH、FT_(3)、FT_(4)水平比较差异无统计学意义(P>0.05);早期治疗组体格发育正常率显著高于晚期治疗组,超重或肥胖发生率远低于晚期治疗组(P<0.05);0.5岁时,早期治疗组患儿DQ显著高于晚期治疗组,2组患儿1、2岁时DQ相较0.5岁时显著增高(P<0.05)。1岁时早期治疗组患儿神经心理发育量表社交行为评分明显高于晚期治疗组(P<0.05)。结论早期治疗可促进先天性甲状腺功能减退症患儿体格、智力及神经系统发育。

Objective To explore effects of different treatment times on physical build,intelligence and nervous system development of children with congenital hypothyroidism.Methods A total of 97 children with congenital hypothyroidism admitted between June 2014 and June 2018 were selected and divided into early treatment group(congenital hypothyroidism diagnosed and treated within 2 months after birth,n=46)and late treatment group(congenital hypothyroidism diagnosed and treated more than 2 months after birth,n=51).After treatment,physical development was compared between two groups;levels of thyroid stimulating hormone(TSH),free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),development quotient(DQ)and conditions of nervous system development at the age of 0.5,1 and 2 years were compared between two groups.Results There were no statistically significant differences in levels of TSH,FT_(3) and FT_(4) at the age of 0.5,1 and 2 years between two groups(P>0.05).In early treatment group,normal rate of physical development was significantly higher,while incidence rates of overweight or obesity were much lower than those in late treatment group(P<0.05).At the age of 0.5 year,DQ level of children in early treatment group was significantly higher than that in late treatment group,and DQ levels of children at the age of 1 and 2 years were significantly higher than those at the age of 0.5 year in two groups(P<0.05).At the age of 1 year,the social behavior score of neuropsychological development scale in early treatment group was significantly higher than that in late treatment group(P<0.05).Conclusion Early treatment may promote the physical build,intelligence and nervous system development in children with congenital hypothyroidism.