目的 分析经新生儿疾病筛查程序诊治的甲状腺功能减低症(congenital hypothyroidism,CH)患儿的神经心理发育情况,为正确评估预后、探索更完善的治疗方案提供依据。方法 采用首都儿科研究所研制的0~6岁婴幼儿神经、心理发育诊断量表对CH患儿的发育商和大运动、精细动作、适应能力、语言、社交行为五大能区进行评价。结果 经新生儿疾病筛查程序诊治的CH患儿神经心理发育水平大部分处于正常水平,各年龄段的CH患儿平均发育商都在85分以上,但是接近正常范围的下限。不同诊断年龄对3岁以内患儿的神经心理发育影响差异无统计学意义。患儿确诊时FT3水平与精细动作、适应能力、语言、社交行为得分呈负相关(r值分别为-0.282、-0.280、-0.276、-0.192,P值均<0.05),患儿确诊时FT₄水平与大运动得分呈正相关(r=0.198,P<0.05)。 结论 经新生儿疾病筛查程序诊治的CH患儿智能水平大部分可达到正常水平,确诊时FT₃水平高和FT₄水平低均可能影响患儿的神经心理发育。

Objective To analyze the neural and psychological development of congenital hypothyroidism (CH) children from the newborn screening for CH,and provide evidences for estimating prognosis and exploring more perfect treatment. Method The DQ,motor,fine movement,adaption,language and social behavior of congenital hypothyroidism children were evaluated using neural and psychological development diagnosis scale for 0~6 years old children. Results Intelligence level of most CH children was in normal range,average scores of DQ were higher than 85 but in low-to-normal level in each age group.Neural and psychological development of CH children of different diagnosis age were not significantly different.The correlations between pretreatment FT₃ and fine movement,adaption,language,social behavior were significant (P<0.05),and the correlation coefficients were -0.282,-0.280,-0.276,-0.192,respectively.The correlation between pretreatment FT₄ and motor was significant (r=0.198,P<0.05). Conclusion Intelligence level of most CH children can achieve normal range.Both high FT₃ level and low FT₄ level can affect the neural and psychological developments of CH children.