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Serological Characteristics, Etiological Analysis, and Treatment Prognosis of Children with Congenital Hypothyroidism
Emergency Medicine International ( IF 1.2 ) Pub Date : 2022-9-27 , DOI: 10.1155/2022/8005848
Lin Shen 1 , Jingchao Ding 2
Affiliation  

Objective. The aim of the study is to analyze the serological features, etiology, and prognosis of congenital hypothyroidism (CH) treated with L-thyroxine sodium (L-T4). Methods. A total of 126 CH children in our hospital from June 2015 to January 2020 were selected as the research objects, and L-T4 treatment was given immediately after diagnosis. After diagnosis and 24 months of treatment, laboratory serum thyroid function-related indicators were examined, and thyroid changes were determined by ultrasound. We compared serum thyroxine levels in children with different thyroid changes, compared serum thyroid hormone levels, serum ghrelin levels, and body mass index (BMI) changes in children with CH before treatment and after 24 months of treatment, and analyzed the prognosis of treatment in children. In terms of thyroid changes in 126 CH children, 32 cases (25.40%) had a normal thyroid gland, 16 cases (12.70%) had a hypoplastic thyroid gland, 40 cases (31.75%) had an ectopic thyroid gland, 28 cases (22.22%) had an absent thyroid gland, and 10 cases (7.93%) had an enlarged thyroid gland, with an ectopic thyroid gland being the most common. In terms of serological expression of CH children, the TSH level in children with thyroid dysplasia was significantly higher than that in children with basic normal and T3 and T4 levels were significantly lower than those in children with basic normal (). At the same time, the TSH level in children with thyroid absence, ectopic, and enlargement was increased, while thyroxine (T4) and tri-iodothyronine (T3) levels were decreased compared with those in children with thyroid dysplasia. The difference was statistically significant (). Univariate analysis showed that there were statistically significant differences in birth weight, week of gestation at delivery, maternal age at childbirth, household registration, and a family history of thyroid disease compared between the two groups (); multivariate logistic regression analysis showed that birth weight <2,500 g, maternal age >35 years, rural residence, and a family history of thyroid disease were risk factors for neonatal CH (). Serum thyroid-stimulating hormone (TSH) levels, serum ghrelin levels, and the body mass index of children with CH decreased significantly, and T4 levels increased significantly after 24 months of treatment (). Conclusion. Screening for common causes of CH is conducive to timely detection of children with CH, and L-T4 treatment can effectively improve thyroid function in children.

中文翻译:

先天性甲状腺功能减退症患儿的血清学特征、病因分析及治疗预后

客观的。本研究的目的是分析 L-甲状腺素钠 (L-T4) 治疗先天性甲状腺功能减退症 (CH) 的血清学特征、病因和预后。方法。选取2015年6月至2020年1月我院收治的126例CH儿童作为研究对象,确诊后立即给予L-T4治疗。诊断后及治疗24个月后,检查实验室血清甲状腺功能相关指标,并通过超声确定甲状腺变化。我们比较了不同甲状腺改变的患儿的血清甲状腺素水平,比较了CH患儿治疗前和治疗24个月后血清甲状腺激素水平、血清Ghrelin水平和体重指数(BMI)的变化,并分析了治疗的预后。孩子们。126例CH儿童甲状腺变化中,甲状腺正常32例(25.40%),甲状腺发育不全16例(12.70%),异位甲状腺40例(31.75%),甲状腺异位28例(22.22%)。 %)甲状腺缺失,10例(7.93%)甲状腺肿大,其中异位甲状腺最常见。CH儿童血清学表达方面,甲状腺不典型增生患儿的TSH水平显着高于基本正常儿童,T3、T4水平显着低于基本正常儿童。)。同时,与甲状腺发育不良患儿相比,甲状腺缺如、异位、肿大患儿的TSH水平升高,而甲状腺素(T4)和三碘甲状腺原氨酸(T3)水平降低。差异有统计学意义()。单因素分析显示,两组出生体重、分娩孕周、产妇分娩年龄、户籍、甲状腺疾病家族史等方面比较,差异有统计学意义。);多因素logistic回归分析显示,出生体重<2500g、孕产妇年龄>35岁、农村居住、有甲状腺疾病家族史是新生儿CH的危险因素。)。治疗24个月后,CH患儿血清促甲状腺激素(TSH)水平、血清生长素释放肽水平和体重指数显着下降,T4水平显着升高。)。 结论。筛查CH常见病因有利于及时发现CH患儿,L-T4治疗可有效改善患儿甲状腺功能。
更新日期:2022-09-27
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