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目的:探讨先天性甲状腺功能减退症(congenital hypothyroidism CH)患儿治疗前后甲状腺功能〔血清游离甲状腺素(free unbound thyroxin FT4)、促甲状腺激素(thyrotropic-stimulating hormone TSH)浓度〕、初始治疗剂量对骨龄发育水平的影响。方法:对坚持左旋甲状腺激素替代治疗3年或3年以上的患儿(分为永久性CH组和暂时性CH组)进行体格发育评价,包括测量身高、体重,计算体质量指数(body mass index BMI);拍摄左手腕骨X线片评定骨龄。结果:①永久性CH组骨龄发育较之暂时性CH组落后(P<0.05);②永久性CH组患儿治疗前FT4、TSH显著低于暂时性CH组(P<0.05);③CH患儿骨龄与初始治疗剂量、治疗前FT4水平有相关性。结论:CH患儿骨龄发育水平与初始治疗剂量、病情严重程度有关;早期足量替代治疗对于促进患儿生长发育、改善预后有重要意义。
Objective: To investigate the effect of thyroid function (free unbound thyroxin FT4, thyrotropic-stimulating hormone TSH) in children with congenital hypothyroidism CH before and after treatment. The initial therapeutic dose on bone age The impact of developmental level. Methods: Physical development was evaluated in children (permanent CH group and temporary CH group) who had been on L-thyroid hormone replacement therapy for 3 years or more, including measuring height and weight, calculating body mass index BMI); left wrist carpus X-ray film to assess bone age. Results: (1) The skeletal age of permanent CH group was significantly lower than that of transient CH group (P <0.05); (2) FT4 and TSH in permanent CH group were significantly lower than those in temporary CH group (P <0.05) Bone age and the initial treatment dose, FT4 levels before treatment are related. Conclusion: The developmental age of bone in children with CH is related to the initial treatment dose and the severity of the disease. Early adequate replacement therapy is of great significance in promoting the growth and prognosis of children.