先天性甲状腺功能减低症治疗前后TSH、FT4、IGF-1水平的变化及与体格生长的关系

中国儿童保健杂志 ›› 2013, Vol. 21 ›› Issue (8): 793-795.

先天性甲状腺功能减低症治疗前后TSH、FT4、IGF-1水平的变化及与体格生长的关系

郑敏,潘莉珍,谭建强,蔡稔

柳州市妇幼保健院内分泌遗传代谢病科,广西柳州 545001

收稿日期:2013-03-20 发布日期:2013-08-06 出版日期:2013-08-06
通讯作者: 蔡稔,E-mail:lzcairen@126.com
作者简介:郑敏(1972-),女,广西人,副主任医师,博士学位,主要研究方向为儿童内分泌疾病。
基金资助:
广西卫生厅课题(Z2012518)

Relationship between physical development and changes of TSH,FT4 and IGF-1 before and after treatment in children with congenital hypothyroidism

ZHENG Min,PAN Li-zhen,TAN Jian-qiang,CAI Ren

Department of Endocrine and Heredity Metabolic Disease,Maternal and Child Health Hospital of Liuzhou City,Liuzhou,Guangxi 545001,China

Received:2013-03-20 Online:2013-08-06 Published:2013-08-06
Contact: CAI Ren,E-mail:lzcairen@126.com

摘要/Abstract

摘要： 目的了解先天性甲状腺功能减低症(congenitial hypothyroidism,CH)患儿经左甲状腺素钠替代治疗前后血清中胰岛素样生长因子-1(IGF-1)、促甲状腺激素(thyroid stimulating hormone,TSH)和游离甲状腺素(free thyroxine,FT4) 水平的变化,并分析这些指标对CH患儿体格发育的影响。方法采集未经治疗的27例CH新生儿和21例治疗后的CH幼儿,30例健康新生儿和30例健康幼儿(作为对照组)的外周静脉血,采用化学发光法测定各组TSH、FT4和IGF-l水平,测量各组体重、身长。结果 CH新生儿组与健康新生儿组相比,血清IGF-1、TSH、FT4水平显著降低(P<0.05)。经一元线性相关分析,CH新生儿IGF-1水平与TSH、FT4、出生体重(body weight,BW)、出生身长(body length,BL)均无明显相关性(P>0.05)。BW、BL与TSH负相关,与FT4正相关。经规范L-T4替代治疗后的CH幼儿组与健康幼儿组相比IGF-1、TSH和FT4水平差异均无统计学意义,两组的体重及身长差异无统计学意义。结论TSH和FT4可能在 CH胎儿期的体格生长中起一定作用。经L-T4替代治疗后TSH、FT4和IGF-1水平升高,这可能是保证CH治疗后正常生长的因素之一。

关键词: 先天性甲状腺功能减低症, 胰岛素样生长因子-1, 体格发育

Abstract: Objective To study the changes of serum insulin-like growth factor-1(IGF-1),thyroid stimulating hormone(TSH) and free thyroxine(FT4) in children with congenital hypothyroidism(CH) by levothyroxine(L-T4) substitution therapy,and to analyse the effects on physical growth in these children. Methods IGF-I,TSH and FT4 were detected by chemiluminescence method which were collected from 27 untreated neonatus with CH,21 children with CH after therapy,30 healthy neonatus and 30 healthy children(as controls).Body weight (BW) and body length (BL) of each groups were measured. Results The levels of serum IGF-1,TSH and FT4 in neonatus with CH were significantly lower than those in healthy neonatus (P<0.05) while there were not differ between healthy children and children with CH after therapy (P>0.05).TSH,FT4,BW and BL had no correlations with IGF-1.BW and BL had inverse correlations with TSH while direct correlations with FT4 in neonatus with CH. Conclusions Physical growth of children with CH in fetal period may be affected by TSH and FT4.The normal levels of TSH,FT4 and IGF-1 may be possible factors for normal growth of children with CH.

Key words: congenital hypothyroidism, insulin-like growth factor-1, physical development

中图分类号:

R723

郑敏,潘莉珍,谭建强,蔡稔. 先天性甲状腺功能减低症治疗前后TSH、FT4、IGF-1水平的变化及与体格生长的关系[J]. 中国儿童保健杂志, 2013, 21(8): 793-795.

ZHENG Min,PAN Li-zhen,TAN Jian-qiang,CAI Ren. Relationship between physical development and changes of TSH,FT4 and IGF-1 before and after treatment in children with congenital hypothyroidism[J]. journal1, 2013, 21(8): 793-795.

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