早期替代治疗对先天性甲状腺功能减退症患儿智能发育的影响  

Influence of Earlier Levothyroxin Replacement on Intellectual Development in Children with Congenital Hypothyroidism

作　　者：陈玉林[1] 孙云[1] 辜楠[1] 张瑾[1] 黄美莲[1] 

机构地区：[1]南京医科大学附属南京市妇幼保健院新生儿科,南京210004

出　　处：《实用儿科临床杂志》2009年第8期603-604,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的分析先天性甲状腺功能减退症(CH)患儿的智能发育,探讨治疗前后甲状腺功能与智能发育水平的关系。方法采用Gesell方法对坚持进行左旋甲状腺素替代治疗的30例经南京市妇幼保健院新生儿筛查中心确诊的CH患儿(CH组)以及30例健康儿童(健康对照组)进行智能测定。2组年龄、性别相匹配。应用荧光法测定患儿治疗前后的甲状腺功能。结果CH组患儿智能均达基本正常(>70),但各能区发育商(DQ值)和总分平均值均显著低于健康对照组(t=-7.02、-3.87、-4.75、-5.77、-6.77、-7.82 Pa<0.01)。各能区DQ值与起始治疗天数呈显著负相关,精细动作、个人社交2个能区的DQ值与治疗前游离甲状腺素水平呈显著正相关(Pa<0.05)。结论早期替代治疗后CH患儿的智能发育基本正常,但仍稍落后于健康儿童。建议在尽早治疗的同时,及时评估,并加强对患儿精细动作和社交能力的训练,将有助于其智能发育,改善预后。Objective To analyze the intellectual development of congenital hypothyroidism （CH） children, and explore the relationship between thyroid gland function and intellectual development. Methods Intellectual development of 30 CH children（ CH group） and 30 normal children（ healthy control group） were tested by Gesell methods. No statistical significance could be detected of age and gender in all cases. The patients＇thyroid function of pretherapy and post - treatment were detected with fluorometric method. Results Intelligence of CH group could reach normal level（〉70） ,but every development quotient（DQ） and mean value were significantly lower than those of healthy control group（t = -7.02, -3. 87, -4.75, -5.77, -6.77, -7.82 P 〈0.01）. Every DQ was inverse correlated with initial therapy time,DQ of fine activities and individual -social intercourse were positive correlated with pretherapy free ghyroxin level（ Pa〈 0.05 ）. Conclusions Intellectual development of CH children reach normal level after earlier levothyroxin replacement, but lower than normal children. Earlier therapy, promptly evaluation and training the abilities of fine activities and social intercourse will contribute to the intellectual development and improve prognosis.

关 键 词：先天性甲状腺功能减退症 智能发育 Gesell法 

分 类 号：R725.8[医药卫生—儿科]