继发性甲状腺功能减退患儿垂体-甲状腺激素改变及治疗探讨  

Pituitary-thyroid hormone levels and hormone replacement therapy in children with secondary hypothyroidism

作　　者：李西霞[1] 陈萍[2] 李桂梅[2] 

机构地区：[1]山东大学校医院儿科,济南250100 [2]山东大学附属省立医院儿科

出　　处：《中华内分泌代谢杂志》2010年第4期284-286,共3页Chinese Journal of Endocrinology and Metabolism

基　　金：基金资助：山东省人事厅2006年度留学回国人员科技活动择优资助;山东省卫生厅2009年立项课题（HW061号）

摘　　要：探讨继发于全垂体功能减退的甲状腺功能减退（继发性甲减）患儿的激素改变及治疗。测定1999年9月至2006年3月以生长迟缓就诊于山东省立医院儿科的57例继发性甲减患儿垂体-靶腺激素，同时观察激素替代治疗的合适剂量。57例继发性甲减患儿FT4均降低，初诊时19例（33．3％）TSH低于正常，38例（66．7％）TSH正常或略高，但L—T4有效治疗后55例（96．5％）TSH低于正常。57例患儿均伴有生长激素缺乏及垂体MRI影像异常。继发性甲减常伴有全垂体功能减退和MRI异常，其治疗目标应使FT4尽快达到并维持在正常上限。To explore the pituitary-thyroid hormone levels and hormone replacement therapy （HRT） in children with secondary hypothyroidism. From September 1999 to March 2006,57 patients with growth retardation and diagnosis of secondary hypothyroidism were enrolled. Serum pituitary hormones were measured, MRI on hypothalamus and pituitary area was evaluated and the appropriate dosage of HRT was investigated. The serum FT4 levels were significantly decreased in all 57 patients （100%） with secondary hypothyroidism. TSH levels were lowered in 19 patients on diagnosis, and within normal range or slightly elevated in the other 38 cases （66.7%）. After levothyroxine （ L-T4） treatment, TSH levels were lowered in 55 patients （96.5%）. Growth hormone deficiency and abnormal MRI images were found in all patients （ 100.0% ）. Secondary hypothyroidism were often associated with multiple pituitary hormone deficiency and abnormal MRI manifestations. FT4 should be maintained within middle to upper limit of normal range, and the hormone levels should be monitored regularly.

关 键 词：继发性甲状腺功能减退症 全垂体功能减退 甲状腺激素 激素替代治疗 

分 类 号：R725.8[医药卫生—儿科]