先天性甲状腺功能减退症患儿骨龄发育研究

目的:探讨先天性甲状腺功能减退症(congenital hypothyroidism CH)患儿治疗前后甲状腺功能〔血清游离甲状腺素(free unbound thyroxin FT4)、促甲状腺激素(thyrotropic-stimulating hormone TSH)浓度〕、初始治疗剂量对骨龄发育水平的影响。方法:对坚持左旋甲状腺激素替代治疗3年或3年以上的患儿(分为永久性CH组和暂时性CH组)进行体格发育评价,包括测量身高、体重,计算体质量指数(body mass index BMI);拍摄左手腕骨X线片评定骨龄。结果:①永久性CH组骨龄发育较之暂时性CH组落后(P0.05);②永久性CH组患儿治疗前FT4、TSH显著低于暂时性CH组(P0.05);③CH患儿骨龄与初始治疗剂量、治疗前FT4水平有相关性。结论:CH患儿骨龄发育水平与初始治疗剂量、病情严重程度有关;早期足量替代治疗对于促进患儿生长发育、改善预后有重要意义。

The research of bone age in Congenital Hypothyroidism

Objective:To investigate the effect of thyroid gland function before and after Levothyroxin replacement therapy(free unbound thyroxin FT4,thyrotropic-stimulating hormone TSH),initial therapy dosage on bone ages in congenital hypothyroidism(CH) children.Methods:To estimate the bone age of CH children who undergo Levothyroxin replacement therapy three or after three years(divided into permanence CH group and temporary CH group),consists of measuring height,weight,calculating body mass index(BMI) and evaluating bone ages through taking leftwrist film.Results:① The bone ages of the permanence CH group were significantly lower than the temporary CH group(P<0.05).② The pretherapy FT4,TSH level of the permanence CH group were significantly lower than the temporary CH group(P<0.05).③The bone ages of CH children were positive correlated with initial therapy dosage and pretherapy FT4 level.Conclusion:It is found that the bone ages of CH children should be concerned with initial therapy dosage and severity of patient's condition.The earlier therapy with sufficient replacement dosage promptly contribute to the development and improve prognosis.