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目的分析与先天性甲状腺功能减退症儿童生长发育相关的因素,以期指导临床治疗。方法选取2010年5月-2015年5月出生于天津市并于该院诊断为先天性甲状腺功能减退症的68例患儿作为研究对象,根据年龄的不同,将其分为观察组(30例)与对照组(38例)。观察组平均年龄为40 d~6个月,对照组平均年龄为6个月~1岁零8个月。一经确诊即服药治疗,于3岁时门诊随诊,记录两组儿童与生长发育有关的数据、首次服药剂量及甲状腺功能(T_3、T_4、FT_3、FT_4、T_SH)等指标,并加以对比分析。结果观察组患儿的平均身高体重等数值均高于对照组患儿,其平均骨龄明显高于对照组,差异具有统计学意义(P<0.05);观察组患儿的各项甲状腺功能指标(T_3、T_4、FT_3、FT_4、T_SH)也优于对照组患儿,差异具有统计学意义(P<0.05);两组患儿的平均骨龄与首次服药剂量及患儿体内的FT_3、FT_4呈显著正相关,差异具有统计学意义(P<0.05)。结论患有先天性甲状腺功能减退症的儿童虽然生长发育较为落后,但若早期发现,早期进行激素替代治疗,患儿往往预后恢复良好,且其发育水平的高低与首次服药剂量及患儿体内的FT_3、FT_4水平也息息相关。
Objective To analyze the factors related to the growth and development of children with congenital hypothyroidism in order to guide the clinical treatment. Methods Sixty-eight children with congenital hypothyroidism diagnosed as congenital hypothyroidism who were born in Tianjin from May 2010 to May 2015 were selected as study subjects and divided into observation group (30 cases ) And control group (38 cases). The average age of the observation group was 40 d to 6 months, and the mean age of the control group was 6 months to 1 year and 8 months. Once diagnosed with medication, they were followed up at the age of 3 years. Data on growth and development of the two groups were recorded. The first dose and thyroid function (T_3, T_4, FT_3, FT_4, T_SH) were recorded and compared. Results The average height and weight of children in the observation group were higher than those in the control group, and the average bone age was significantly higher than that in the control group (P <0.05). The thyroid function indexes T_3, T_4, FT_3, FT_4 and T_SH) were also better than those in the control group (P <0.05). The average bone age and the first dose and FT_3 and FT_4 in children were significantly higher than those in the control group Positive correlation, the difference was statistically significant (P <0.05). Conclusion Although children with congenital hypothyroidism are relatively backward growth and development, but if early detection of early hormone replacement therapy, children often have a good prognosis recovery, and its level of development and the first dose and the amount of children in vivo FT_3, FT_4 level is also closely related.