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目的了解先天性甲状腺功能减低症(congenital hypothyroidsm,CH)甲状腺变化和甲状腺素治疗的效果。方法对2000年～2009年济宁市筛查出的357例患儿进行甲状腺核素扫描,确定CH患儿甲状腺改变,并给予L-T4治疗,定期进行体重、身高和智力监测,评价治疗效果。结果在筛查的681 289例新生儿中,确诊CH 367例,发病率为1∶1817;其中357例甲状腺扫描显示甲状腺正常、发育不良、异位、缺如和摄锝功能低下的分别占61.03%、12.53%、10.08%、9.54%和6.81%。在患儿确诊后根据血清TSH、FT3、FT4含量,患儿2月内采用L-T4治疗,治疗剂量12.5～75.5μg/d,平均50.25μg/d,系统治疗后患儿体重中下等1例,占0.28%,中等以上356例,占99.72%,身高中下等2例,占0.56%,中等以上355例,占99.44%;智商在81～121之间,智商分级低于平常1例,占0.28%,平常以上356例,占99.72%。结论依据甲状腺核素扫描进行CH的早期诊断和早期治疗对于CH患儿的体格和智能发育有非常重要的作用。
Objective To investigate the effect of congenital hypothyroidism (CH) thyroid changes and thyroxine treatment. Methods A total of 357 children screened from 2000 to 2009 in Jining City were screened for thyroid radionuclide. Thyroid gland changes were confirmed in CH children. L-T4 treatment was performed. Body weight, height and intelligence were monitored periodically to evaluate the therapeutic effect. Results Of the 681 289 newborns screened, 367 cases were diagnosed as CH with a prevalence of 1:1817. Among them, 357 thyroid scans showed normal thyroid gland, dysplasia, ectopic, absent, and hypoglycemic dysfunction accounted for 61.03 %, 12.53%, 10.08%, 9.54% and 6.81%. According to the serum levels of TSH, FT3 and FT4, the patients were treated with L-T4 within two months after treatment. The therapeutic dose was 12.5-75.5μg / d, with an average of 50.25μg / d. The systemic weight of patients with lower body weight 1 Cases, accounting for 0.28%, 356 cases above the average, accounting for 99.72%, 2 cases of height in the lower half, accounting for 0.56%, 355 cases above average, accounting for 99.44%; IQ between 81 to 121, IQ classification lower than usual , Accounting for 0.28%, usually more than 356 cases, accounting for 99.72%. Conclusion The early diagnosis and early treatment of CH according to thyroid radionuclide scanning are very important for the physical and intellectual development of children with CH.