左甲状腺素替代疗法治疗甲状腺功能减退症患儿的效果

Effects of Levothyroxine replacement therapy on children with hypothyroidism

目的:观察左甲状腺素替代疗法治疗甲状腺功能减退症(简称“甲减”)患儿的效果。方法:选取2020年3月至2021年12月该院收治的60例甲减患儿进行前瞻性研究,按照随机数字表法分为对照组与观察组各30例。对照组采用正常喂养和照护,观察组在对照组基础上采用左甲状腺素替代疗法治疗,比较两组疗效,治疗前后身高、体质量、Gesell发育量表评分、炎性因子[血清超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平和甲状腺相关激素指标[促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺球蛋白抗体(TGAb)]水平。结果:治疗后,两组身高和体质量均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组大运动、精细动作、适应能力、语言、个人-社交行为等Gesell发育评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组hs-CRP、IL-6、TNF-α、TSH、TGAb水平均低于治疗前,且观察组低于对照组,两组FT3、FT4水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为96.67%,明显高于对照组的73.33%,差异有统计学意义(P<0.05)。结论:在正常喂养和照护基础上采用左甲状腺素替代疗法治疗甲减患儿可提高治疗总有效率、身高、体质量和Gesell发育评分,改善甲状腺相关激素指标水平,降低炎性因子水平,优于单纯正常喂养和照护效果。

Objective:To observe effects of Levothyroxine replacement therapy in treatment of children with hypothyroidism.Methods:A prospective study was conducted on 60 children with hypothyroidism admitted from March 2020 to December 2021.They were divided into control group and observation group according to the random number table method,30 cases in each group.The control group was treated with normal feeding and nursing,while the observation group was treated with Levothyroxine replacement therapy on the basis of that of the control group.The total effective rate of treatment,the height,the body mass,the Gesell development scale score,the inflammatory factor levels[serum high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],and the thyroid related hormone levels[thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),thyroglobulin antibody(TGAb)]were compared between the two groups.Results:After the treatment,the height and body mass of both groups were higher than those before treatment,and the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the Gesell development scores of gross motor,fine motor,adaptability,language and personal-social behavior in the two groups were higher than those before the treatment,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of hs-CRP,IL-6,TSH,TGAb and TNF-αin the two groups were lower than those before the treatment,those in the observation group were lower than the control group;the levels of FT3 and FT4 in the two groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;and the differences were statistically significant(P<0.05).Further,the total effective rate of treatment in the observation group was 96.67%,which was significantly higher than 73.33%in the control group,the difference was statistically significant(P<0.05).Conclusions:On the basis of the normal feeding and nursing,Levothyroxine replacement therapy can improve the total effective rate,height,body mass and Gesell development score,improve the levels of thyroid related hormones and reduce the levels of inflammatory factors in the children with hypothyroidism.Mo reover,it is superior to single normal feeding and nursing.