血清25羟维生素D水平与左旋甲状腺素治疗新生儿先天性甲状腺功能低下远期疗效的相关性  

Correlation between serum 25-(OH)-D level and long-term efficacy of levothyroxine in treatment of neonatal congenital hypothyroidism

作　　者：张祥生[1] ZHANG Xiangsheng(Wuhu Hospital for Maternal and Child Health,Anhui,Wuhu 241000,China)

机构地区：[1]安徽省芜湖市妇幼保健院,241000

出　　处：《河北医药》2021年第13期1972-1975,共4页Hebei Medical Journal

摘　　要：目的观察新生儿先天性甲状腺功能低下(CH)经左旋甲状腺素(L-T4)治疗的远期疗效,并分析疗效与血清25羟维生素D[25-(OH)-D]水平的关系。方法收集2014年1月至2017年12月分娩的65例新生儿CH患儿病历资料,所有患儿均接受L-T4规范治疗,并获得随访结果。随访结束时,参照韦氏幼儿智力量表(C-WYCSI)评估患儿远期疗效并分组;检测患儿治疗前血清25-(OH)-D水平,分析血清25-(OH)-D与CH患儿经L-T4治疗远期疗效的相关性。结果65例CH患儿评估结果显示,疗效不佳16例占24.62%;疗效较好49例,占75.38%;疗效不佳组患儿血清胰岛素样生长因子-1(IGF-1)、25-(OH)-D水平均低于疗效较好组(P<0.05);二元Logistic回归分析结果显示,血清IGF-1、25-(OH)-D低表达均是CH患儿L-T4治疗远期疗效不佳的影响因素(OR>1,P<0.05);绘制ROC曲线发现,血清25-(OH)-D水平预测CH患儿L-T4治疗远期疗效不佳的AUC为0.885,有一定预测价值。结论血清25-(OH)-D低表达可能预示CH患儿L-T4治疗后远期疗效不佳,临床可早期监测患儿血清25-(OH)-D水平,对预测、评估患儿远期疗效有一定积极意义。Objective To investigate the long-term efficacy of levothyroxine(L-T4)in treatment of neonatal congenital hypothyroidism(CH),and to analyze the correlation between curative effects and serum levels of 25-hydroxyvitamin D[25-(OH)-D].Methods The clinical data about 65 neonates with CH who were born in our hospital from January 2014 to December 2017 were retrospectively analyzed.All the neonates received L-T4 standard treatment,and were followed up.At the end of the follow up,the long-term curative effects were evaluated according to the Wechsler child intelligence scale(C-WYCSI).Moreover the serum levels of 25-(OH)-D were detected before treatment,and the correlation between curative effects and serum levels of 25-(OH)-D was analyzed.Results Of the 65 neonates,16 cases had poor efficacy,accounting for 24.62%;49 cases had better efficacy,accounting for 75.38%.The serum levels of insulin-like growth factor-1(IGF-1)and 25-(OH)-D in poor efficacy group were significantly lower than those in better efficacy group(P<0.05).The binary Logistic regression analysis showed that the low expressions of serum IGF-1 and 25-(OH)-D were influencing factors for the poor long-term efficacy(OR>1,P<0.05).The ROC curve was drawn and found that AUS of 25-(OH)-D in predicting poor efficacy after L-T4 treatment was 0.885,which had certain predictive value.Conclusion The low expression of serum 25-(OH)-D may indicate the poor long-term efficacy in neonates with CH after L-T4 treatment.Early clinical monitoring of serum 25-(OH)-D levels has positive significance for predicting and evaluating the long-term curative effects.

关 键 词：先天性甲状腺功能低下 左旋甲状腺素 远期疗效 血清25羟维生素D 

分 类 号：R581[医药卫生—内分泌]