儿童先天性甲状腺功能异常与智能发育的关系

Relationship between the children with inherent thyroid gland dysfunction and their intellectual development

目的:探讨儿童先天性甲状腺功能异常与其智能发育的关系。方法:采用对照研究的方法,对出生时甲状腺素(TSH)介于5～20mU/L的2～4岁儿童(n=198)使用DDST进行筛查,同时设置正常儿童对照组(n=198,TSH≤5mU/L)进行对比研究,对筛查出的问题儿童,再次使用儿童神经心理发育量表进行测查,进一步明确先天性甲状腺功能异常与智能发育的关系。结果:①经DDST筛查,对照组儿童智能发育正常的比例为100%,实验组儿童智能发育正常的比例为93.9%,发育可疑的比例为4.0%,发育异常的比例为2.0%,经统计学检验,两组儿童筛查结果具有显著性差异(χ2=12.37,P<0.005)。②经儿童神经心理发育量表测试,本研究中儿童智能发育处于中等以下水平的比例为1.25%。③经多元逐步回归分析发现儿童TSH水平、早期教育因素、家庭经济状况、儿童营养状况、家庭重视程度为影响DDST筛查结果的主要因素。结论:儿童先天性甲状腺功能异常是影响儿童智能发育的重要相关因素。

AIM:To explore the relationship between the children with inherent thyroid gland dysfunction and their intellectual development. METHOD:DDST was used to screen 198 children aged 2- 4 years, 112 male and 86 female, with thyroid stimulating hormone(TSH) between 5 and 20 mU/L when born. Simultaneously, 198 age matched normal children from the same region, with TSH ≤ 5 mU/L, were used as controls. Problem children were measured again by Child Nerve Mental Development Scale to further verify the relationship between inherent thyroid gland dysfunction and intellectual development. RESULT:① DDST screening showed that the rate of normal development in the control group was 100% , while that of the experimental group was 93.9% . The rates of suspicious development and abnormal development were 4.0% and 2.0% in the experimental group respectively. There was a significant difference between the development of the two groups (χ 2=12.37, P< 0.005).② Child Nerve Mental Development Scale indicated that about 1.25% children's intelligence were below the normal level in this research.③ Multiply stepwise regression analysis showed that the TSH level, early education, economic status, nutritional status and family attention degree were the main factors to influence the screening of DDST.