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目的:评估甲状腺功能减退症(CH)的筛查、早期诊断及治疗管理路径的合理性。方法:回顾分析5年来对新生儿期CH筛查、早期诊断及治疗的管理路径,对召回儿童进行专案管理的资料进行系统的对比分析,找出最佳用药剂量与最佳监测项目间的关系。结果:从甲状腺功能低下和高TSH血症治疗用药的首剂用药量、首次用药稳定量、3m～、6m～、直至48 m各个时段的用药量,30m～以内均显示出差异性(P<0.05);且甲状腺功能低下治疗用药的各个时段均有极显著性差异(P<0.01)。用药剂量调整幅度在3～6m、6～9m有差异显著性(P<0.05),在9～12m后各个时段用药剂量调整幅度则无差异显著性(P>0.05)。CH患者治疗后在3月龄、6月龄、8月龄、1岁、2岁和3岁与正常婴幼儿在体重、身长、智能发育、神经反射发育方面无差异显著性(P>0.05),在骨强度、骨碱性磷酸酶、铁和锌元素方面,CH和高TSH患者则有显著差异性(P<0.05)。结论:婴幼儿CH的早期筛查、诊断及治疗对婴幼儿的健康成长具有重要意义。
Objective: To evaluate the rationality of screening, early diagnosis and treatment management of hypothyroidism (CH). Methods: A retrospective analysis of five years of neonatal CH screening, early diagnosis and treatment of management approach to the recall of children project management data to conduct a systematic comparative analysis to find the best dosage and the relationship between the best monitoring project . Results: The dosage of the first dose of hypothyroidism and TSS hyperlipidemia treatment, the first dose of drug, the dosage of 3m ~, 6m ~, 48m each time showed the difference within 30m ~ (P <0.05 ); And hypothyroidism medication at all times have significant differences (P <0.01). The dose adjustment ranged from 3 to 6 m, with a significant difference from 6 to 9 m (P <0.05). There was no significant difference (P> 0.05) in dose adjustment between 9 and 12 m after treatment. CH patients had no significant difference in body weight, length, intelligence development and reflex development at 3 months, 6 months, 8 months, 1, 2 and 3 years after treatment (P> 0.05) There was significant difference between CH and high TSH in bone strength, bone alkaline phosphatase, iron and zinc (P <0.05). Conclusion: The early screening, diagnosis and treatment of CH in infants and young children are of great significance to the healthy growth of infants.