1.Clinical study on thyroid function in children with congenital hypothyroidism
Linger XU ; Jiancheng MAO ; Lidan MAO ; Yingying CHENG
Chinese Journal of Primary Medicine and Pharmacy 2022;29(4):521-525
Objective:To investigate thyroid function, physical growth, and psychological and behavioral development in children with congenital hypothyroidism.Methods:Thirty-two children with congenital hypothyroidism who were born in Yuyao People's Hospital from January 2014 to December 2018 were included in the observation group. Thirty healthy neonates who were born in the same period were included in the control group. Thyroid function index changes at the age of 1 year relative to at birth, physical, intellectual, and neuropsychological development and bone age at the age of 1 year were compared between the observation and control groups.Results:Thyroid-stimulating hormone level at birth was significantly higher in the observation group than in the control group [(18.23 ± 2.71) mU/L vs. (2.85 ± 0.34) mU/L, t = 30.84, P < 0.001]. Free thyroxine level at birth was significantly lower in the observation group than in the control group [(6.76 ± 1.54) pmol/L vs. (17.91 ± 2.04) pmol/L, t = 24.39, P < 0.001]. In the observation group, thyroid-stimulating hormone and free thyroxine levels at the age of 1 year were (2.68 ± 0.78) mU/L and (17.26 ± 2.11) pmol/L, respectively, which were not significantly different from those in the control group [(2.77 ± 0.63) mU/L and (17.54 ± 2.20) pmol/L, t = 0.50, 0.51, both P > 0.05]. Body weight, body length, head circumference, and bone age at the age of 1 year were (9.21 ± 1.20) kg, (79.84 ± 3.05) cm, (43.73 ± 1.42) cm, (1.01 ± 0.15) years old, respectively in the observation group, which were significantly lower than those in the control group [(10.12 ± 1.32) kg, (84.54 ± 3.41) cm, (45.85 ± 2.04) cm, (1.14 ± 0.28) years old, t = 2.84, 5.73, 4.77, 2.30, P < 0.05]. The proportion of children patients with bone age lag was significantly higher in the observation group than in the control group [21.88% (7/32) vs. 3.33% (1/30), χ2 = 4.74, P < 0.05]. There was a significant difference in intellectual development at the age of 1 year between the two groups ( χ2 = 7.05, P < 0.05). Gross movement, fine movement, adaptability, language ability, and social ability in the observation group were scored (90.43 ± 6.96) points, (92.03 ± 6.03) points, (88.45 ± 4.85) points, (84.04 ± 5.71) points, and (85.05 ± 6.17) points, respectively, which were significantly lower than those in the control group [(99.47 ± 5.40) points, (104.12 ± 5.71) points, (98.47 ± 5.22) points, (94.16 ± 4.98) points, and (104.34 ± 5.70) points ( t = 5.69, 8.09, 7.84, 7.42, 12.76, all P < 0.001]. Conclusion:Neonate patients with congenital hypothyroidism have obvious physical growth and psychological and behavioral development disorders. Early screening and treatment of neonatal congenital hypothyroidism should be strengthened to improve the prognosis.