目的 分析影响先天性甲状腺功能减低症(congenital hypothyroidism,CH)患儿治疗转归的相关因素,为判断治疗转归提供依据。方法 对规范治疗后424例先天性CH患儿治疗转归的可能相关因素进行回顾性分析总结。采用Logistic多元回归分析影响先天性CH患儿治疗转归的相关因素。结果 相关因素中,甲状腺彩超异常(提示甲状腺发育异常)组有显著意义,两组间差异有统计学意义(P<0.01) ,性别组、是否并发缺血缺氧性脑病组、高胆红素血症组、确诊时促甲状腺素异常值的高低组,相应两组间差异均无统计学意义(P>0.05) 。结论 先天性CH患儿治疗转归与出生时甲状腺发育异常有关,而与性别、出生时是否并发缺血缺氧性脑病、高胆红素血症、确诊时促甲状腺素异常的高低均无关系。出生时甲状腺彩超有助预示治疗后的转归。
Abstract
Objective To analyse the related factors of influence to children with congenital hypothyroidism (CH) after treatment outcome,and to provide the basis for judging treatment outcome. Methods By grouping comparison,in the statistical chi-square analysis,to retrospectively analyse and summarize the possible related factors of 424 cases of children with CH after standard treatment.To analyse the related factors of influence to children with CH after treatment outcome using Logistic multivariate regression analysis. Results There were statistically significant differences between the two groups of the abnormal thyroid after color Doppler ultrasound checked (suggest thyroid dysplasia)(P<0.01),no significant differences was found among gender groups,the groups whether concurrent hypoxic-ischemic encephalopathy (HIE),the high blood bilirubin groups,and the groups of thyroid-stimulating hormone (TSH) outliers when confirmed,the differences between the corresponding two groups were not statistically significant (P>0.05). Conclusion It is found that the treatment outcome for children with CH should be concerned with thyroid dysplasia at birth,and shouldn't be concerned with gender,HIE,high blood bilirubin at birth and the outliers of TSH when confirmed.Color Doppler ultrasound checked for thyroid at born can help to predict the outcome after treatment.
关键词
先天性甲状腺功能减低症 /
甲状腺发育异常 /
治疗转归
Key words
congenital hypothyroidism /
malformation thyroid /
treatment outcome
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参考文献
[1] 中华人民共和国卫生部.新生儿疾病筛查技术规范[Z].2010版.2011.11.10.
[2] 中华医学会儿科学分会内分泌遗传代谢学组.先天性甲状腺功能减低症诊疗共识[J].中华儿科杂志,2011,49(6):421-423.
[3] 颜纯,王慕逖.小儿内分泌学[M].2版.北京:人民卫生出版社,2006:155-174.
[4] Lavin N.内分泌学及代谢疾病诊治手册[M].姬秋和,张世俊.4版.北京:人民军医出版社,2012:493-511.
[5] Rubio IG,Galrao AL,Pardo V,et al.A molecular analysis and long-term follow-up of two siblings with severe congenital hypothyroidism carrying the IVS30+1G>T intronic thyroglobulin mutation[J].Arq Bras Endocrinol Metabol,2008,5281:1337-1344.
[6] 张成,张立琴,苏乃仑.学龄前先天性甲状腺功能减低症患儿生长发育及其影响因素的研究[J].中国优生与遗传杂志,2012,20(10):124-126.
[7] 徐艳华,秦玉峰,赵正言.中国新生儿先天性甲状腺功能低下症与苯丙酮尿症筛查22年回顾[J].中华儿科杂志,2009,47(1):18-22.
[8] 顾学范,王治国.中国580万新生儿苯丙酮尿症和先天性甲状腺功能减低症的筛查[J].中华预防医学杂志,2004,38(2):99-102.
[9] 李海飞,刘一心,谢建生,等.先天性甲状腺功能减低症35例甲状腺过氧化物酶基因突变检测[J].中华儿科杂志,2011,49(8):626-630.
[10] Michael SK,David BA,Mitchell EG.儿科内分泌学-诊治与实践[M].陈晓波.北京:人民军医出版社,2012:104-125.
[11] 魏书珍,张秋业.儿童生长发育性疾病[M].北京:人民卫生出版社,2004:273-277.