不同剂量左旋甲状腺素治疗新生儿先天性甲状腺功能减退症的临床效果分析  

Analysis of Clinical Effect of Levothyroxine at Different Doses in Treatment of Neonatal Congenital Hypothyroidism

作　　者：伏小建 樊晓艳 Fu Xiaojian;Fan Xiaoyan(Taizhou Maternal and Child Health Center,Taizhou 225300,Jiangsu Province,China;The Affiliated Taizhou People's Hospital of Nanjing Medical University,Taizhou 225300,Jiangsu Province,China)

机构地区：[1]泰州市妇幼保健所,江苏泰州225300 [2]南京医科大学附属泰州人民医院,江苏泰州225300

出　　处：《中国社区医师》2024年第33期62-64,共3页Chinese Community Doctors

摘　　要：目的:分析不同剂量左旋甲状腺素治疗新生儿先天性甲状腺功能减退症的临床效果。方法:选取2018年1月—2022年12月于泰州市妇幼保健所新生儿疾病筛查中心确诊的先天性甲状腺功能减低症患儿70例作为研究对象,随机分成对照组和观察组,各35例。两组均给予左旋甲状腺素治疗,对照组初始剂量为6~10μg/(kg·d),观察组初始剂量为10~15μg/(kg·d)。比较两组甲状腺激素水平、身高、体质量及智力水平。结果:治疗前、治疗2周后、1岁、2岁时,两组甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))水平比较,差异无统计学意义(P>0.05);治疗2周后、1岁、2岁时,两组TSH水平均低于治疗前,FT_(3)、FT_(4)水平均高于治疗前(P<0.05)。治疗前、1岁、2岁时,两组身高、体质量比较,差异无统计学意义(P>0.05);1岁、2岁时,两组身高高于治疗前,且体质量大于治疗前(P<0.05)。2岁时,两组身高高于1岁,且体质量大于1岁(P<0.05)。2岁时,两组大运动、精细动作、适应能力、语言、个人社交行为评分均高于1岁(P<0.05)。1岁、2岁时,观察组大运动、精细动作、适应能力、语言、个人社交行为评分均高于对照组(P<0.05)。结论:左旋甲状腺素治疗新生儿先天性甲状腺功能减退症的临床效果显著,能够在短期内改善患儿的甲状腺激素水平,促进其机体生长发育。与小剂量相比,初始剂量较高[10.1~15.0μg/(kg·d)]的左旋甲状腺素能够显著改善患儿的智力水平。Objective:To analyze the clinical effect of levothyroxine at different doses in treatment of neonatal congenital hypothyroidism.Methods:A total of 70 children with congenital hypothyroidism diagnosed at the Neonatal Disease Screening Center of Taizhou Maternal and Child Health Center from January 2018 to December 2022 were selected as the study subjects.They were randomly divided into control group and observation group,with 35 cases in each group.Both groups were treated with levothyroxine,with the initial dose of 6-10μg/(kg·d)in the control group and 10-15μg/(kg·d)in the observation group.The levels of thyroid hormone,body height,body weight and intelligence were compared between the two groups.Results:There was no significant difference in the levels of thyroid hormone(TSH),free triiodothyronine(FT_(3))and free thyroxine(FT_(4))between the two groups before treatment,after 2 weeks of treatment,and at 1 year and 2 years of age(P>0.05).After 2 weeks of treatment and at 1 year and 2 years of age,the levels of TSH in the two groups were lower than those before treatment,and the levels of FT_(3) and FT_(4) in the two groups were higher than those before treatment(P<0.05).Before treatment and at 1 year and 2 years of age,there was no significant difference in body height and body weight between the two groups(P>0.05).At 1 year and 2 years of age,the body heights in the two groups were higher than those before treatment,and the body weights in the two groups were greater than those before treatment(P<0.05).At 2 years of age,the body heights in the two groups were higher than those at 1 year of age,and the body weights in the two groups were greater than those at 1 year of age(P<0.05).At 2 years of age,the scores of gross motor,fine motor,adaptability,language,and personal social behavior in the two groups were higher than those at 1 year of age(P<0.05).At 1 year and 2 years of age,the scores of gross motor,fine motor,adaptability,language,and personal social behavior in the observation group were higher than thos

关 键 词：左旋甲状腺素 新生儿 先天性甲状腺功能减退症 

分 类 号：R722.1[医药卫生—儿科]