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【目的】分析经新生儿疾病筛查程序诊治的甲状腺功能减低症(congenital hypothyroidism,CH)患儿的神经心理发育情况,为正确评估预后、探索更完善的治疗方案提供依据。【方法】采用首都儿科研究所研制的0～6岁婴幼儿神经、心理发育诊断量表对CH患儿的发育商和大运动、精细动作、适应能力、语言、社交行为五大能区进行评价。【结果】经新生儿疾病筛查程序诊治的CH患儿神经心理发育水平大部分处于正常水平,各年龄段的CH患儿平均发育商都在85分以上,但是接近正常范围的下限。不同诊断年龄对3岁以内患儿的神经心理发育影响差异无统计学意义。患儿确诊时FT3水平与精细动作、适应能力、语言、社交行为得分呈负相关(r值分别为-0.282、-0.280、-0.276、-0.192,P值均<0.05),患儿确诊时FT4水平与大运动得分呈正相关(r=0.198,P<0.05)。【结论】经新生儿疾病筛查程序诊治的CH患儿智能水平大部分可达到正常水平,确诊时FT3水平高和FT4水平低均可能影响患儿的神经心理发育。
【Objective】 To analyze the neuropsychological development in children with congenital hypothyroidism (CH) diagnosed and treated by the neonatal screening program, and provide the basis for the correct assessment of the prognosis and exploration of a more complete treatment plan. 【Methods】 Five children with CHD, including developmental traits, motor traits, fine motor ability, adaptability, language and social behavior, were evaluated using the Diagnostic Scale for Neurological and Psychological Development of Children 0- to 6-year-old developed by Capital Institute of Pediatrics. 【Results】 Most of children with CH diagnosed and treated by neonatal disease screening program were at normal level. The average developmental age of CH children in all ages was over 85, but close to the lower limit of normal range. There was no significant difference in the neuropsychological development of children under 3 years old at different diagnostic ages. The level of FT3 in children with definite diagnosis was negatively correlated with fine motor ability, language ability and social behavior score (r = -0.282, -0.280, -0.276, -0.192, P <0.05, respectively) There was a positive correlation between level and grand scale score (r = 0.198, P <0.05). 【Conclusion】 The majority of CH children diagnosed and treated by neonatal disease screening program can reach normal level. The high level of FT3 and the low level of FT4 may affect the neuropsychological development in children.