Effect of early screening and intervention on congenital hypothyroidism
10.3760/cma.j.issn.1008-6706.2016.15.008
- VernacularTitle:早期筛查及干预对先天性甲状腺功能低下的预防作用
- Author:
Guiying QU
;
Jianping YANG
;
Fuyin ZHANG
;
Aiping LIU
;
Yanyan YANG
- Publication Type:Journal Article
- Keywords:
Congenital;
Hypothyroidism;
Thyroid stimulating hormone;
Newborn;
Ultrasound
- From:
Chinese Journal of Primary Medicine and Pharmacy
2016;23(15):2268-2271
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of early screening and intervention on congenital hypothyroid-ism.Methods Thyroid stimulating hormone (TSH),three thyroid stimulating hormone (T3 )and thyroid hormone (T4 )were screened in 72h after birth,and thyroid ultrasound examination.All the patients were treated with the treat-ment of the left -to -thyroid hormone,0 -6 months medication dose 25 -50g/d,6 -12months medication dose 50 -100g/d,1 -3months medication dose 75 -100g/d.Serum TSH was reviewed every three months in the age of 1 years, 2 -3 years old every six months to review the serum TSH.Results The mean value of TSH in children with congeni-tal hypothyroidism was (68.7 ±15.3)mU /L.The mean value of T4 was (42.4 ±13.1)nmol/L.100 cases of chil-dren,including 38 cases of primary congenital hypothyroidism,transient congenital hypothyroidism in 62 cases.Ultra-sound examination showed primary congenital hypothyroidism were developmental abnormalities,and abnormal absence of a total of 18 cases (47.4%),Abnormal blood flow in 15 cases (39.5%);No abnormalities were found in the ultrasound examination of the transient congenital hypothyroidism.Before treatment,TSH in children with congenital hypothyroidism was significantly higher than that in the control group[(68.7 ±15.3)mU /L vs (4.6 ±1.1)mU /L], T4 was significantly lower than the control group[(42.4 ±13.1)nmol/L vs (124.4 ±45.5)nmol/L],the differences
were statistically significant (t =22.867,16.058,all P <0.05);After treatment,the TSH of the children was signifi-cantly decreased[(5.3 ±1.1)mU /L vs (68.7 ±15.3)mU /L],and the T4 was significantly increased[(114.5 ± 35.4)nmol/L vs (42.4 ±13.1)nmol/L],compared with before treatment,the differences were statistically significant (t =41.331,19.101,all P <0.05 ),but compared with the control group,there were no significant differences between TSH and T4 (all P >0.05).After 1 -3 years follow -up observation,children with Gesell development scale test showed that children with adaptability,large movements,fine movements,language and social skills to reach the normal level.Conclusion Early screening and treatment of the patients with congenital hypothyroidism is beneficial to the rehabilitation of the patients with congenital hypothyroidism.
