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目的探讨左旋甲状腺素钠替代治疗先天性甲状腺功能减低症(CH)的初始剂量。方法选取CH新生儿42例并随机分组,对照组20例,观察组22例,分别给予不同初始剂量的左旋甲状腺素钠,测定两组各时段的甲状腺功能,并行2年随访观察患儿智力发育情况。结果两组患儿在应用左旋甲状腺素钠治疗后血清促甲状腺激素(TSH)显著下降,血清甲状腺素(T4)与血清游离甲状腺素(FT4)显著升高,且两组各时段各指标比较差异均无统计学意义;治疗4周后观察组TSH、FT4、T4正常率均显著低于对照组;经2年随访两组患儿智力水平比较差异无统计学意义。结论左旋甲状腺素钠替代治疗对先天性甲状腺功能减低症有显著治疗效果,两组初始剂量对患儿体格及智力发育的影响比较差异无统计学意义,但对照组稍有不足,观察组量稍大,在替代治疗过程中应选用二者中间剂量治疗。
Objective To investigate the initial dose of levothyroxine replacement therapy for congenital hypothyroidism (CH). Methods Forty-two neonates with CH were randomly divided into control group (n = 20) and observation group (n = 22). Thyroxine sodium was administered at different initial doses. Thyroid function was measured at each time point and followed up for 2 years. Happening. Results After treatment with levothyroxine sodium, serum thyrotropin (TSH) was significantly decreased, serum thyroxine (T4) and serum free thyroxine (FT4) were significantly increased in both groups, and there were significant differences between the two groups There was no significant difference between the two groups after 4 weeks of treatment. The normal rates of TSH, FT4 and T4 in the observation group were significantly lower than those in the control group after 4 weeks of treatment. There was no significant difference in intelligence between the two groups after 2 years of follow-up. Conclusions L-thyroxine sodium replacement therapy has a significant therapeutic effect on congenital hypothyroidism. There is no significant difference between the two groups in initial dose on physical and mental development, but the control group is slightly deficient. Large, in the alternative treatment process should choose between the two intermediate doses.