Early predictors for outcomes of congenital hypothyroidism in neonates
10.3760/cma.j.cn114798-20200726-00857
- VernacularTitle:先天性甲状腺功能减低症不同转归的早期预测因子探讨
- Author:
Huixia FAN
1
;
Miaomiao GAO
;
Yaqiong YAN
;
Xiaoyu LI
Author Information
1. 山西省妇幼保健院，太原 030013
- From:
Chinese Journal of General Practitioners
2020;19(12):1141-1146
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore early predictive factors for outcomes of congenital hypothyroidism (CH) in neonates.Methods:A total of 242 neonates diagnosed as CH in Shanxi Provincial Newborn Disease Screening Center from October 2009 to October 2014 were enrolled in the study. All CH children were treated with levothyroxine sodium (L-T 4) for 2-3 years and continued to follow up for more than 1 year after drug withdrawal. Seventy two cases dropped out during the follow-up; among 170 patients entering the final analysis, there were 61 cases of permanent congenital hypothyroidism (PCH group) and 109 cases of transient congenital hypothyroidism (TCH group). The clinical data and the L-T 4 dose during follow-up period were compared between two groups; and the predicting factors of clinical outcomes were analyzed. Results:There were significant differences in baseline thyroid stimulating hormone(TSH)level [127.0 (83.7,175.4) μIU/ml vs. 55.8(22.1,102.5)μIU/ml], initial treatment timing [26.0(20.5,34.5)d vs. 31.0(24.0,37.5)d], time required for TSH to return to normal [52.0(33.0,71.5)d vs.36.0(32.0,41.5)d], and thyroid ultrasound results [18.3%(11/60) vs. 94.0%(78/83)] between PCH group and TCH group. The initial screening TSH levels in children (optimal cut-off: 71.29 μIU/ml) and L-T 4 dose at 7 months after diagnosis (optimal cut-off: 24.4 μg/d) can be used for early differentiation between children with PCH and TCH. Conclusion:The initial TSH screening levels and the dose of L-T 4 during the follow-up period have predictive value for early differentiation of PCH and TCH in children.
