Linear growth and neurodevelopmental outcome of children with congenital hypothyroidism detected by neonatal screening: A controlled study.
Linear growth and neurodevelopmental outcome of children with congenital hypothyroidism detected by neonatal screening: A controlled study.
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DOI：
10.4103/2230-8210.98012
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发表时间：
2012-07
影响因子：
--
通讯作者：
Sabt A
中科院分区：
文献类型：
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作者：
Soliman AT;Azzam S;Elawwa A;Saleem W;Sabt A
不同的生长和神经发育结果与给予先天性甲状腺功能减退症（CH）婴儿不同剂量的甲状腺素有关。我们研究了45名CH儿童的纵向生长模式并评估了其神经发育（25名女孩，20名男孩）通过卡塔尔的国家筛查项目确诊，6年或更长时间，以检查初始T4剂量的影响（50 μg/天），同时调整T4剂量，以维持血清游离T4浓度在正常范围的上四分位数内，促甲状腺激素< 4 mIU/对2003年1月以前通过筛查诊断为CH的新生儿的出生体尺进行记录，并每3个月监测一次体重和身高的增长，至少持续6年。采用韦氏学龄前和小学智力量表（WPPSI-III）对3 ~ 6岁儿童的智商进行评估。患者的出生体重、身长和头围（分别为3.21 ± 0.43 kg、50.5 ± 3.21 cm和34.1 ± 1.5 cm）与10,560例甲状腺功能正常的正常新生儿（3.19 ± 0.59 kg、50.5 ± 2.2 cm和34.2 ± 1.7 cm）无差异。1岁时CH患儿的生长（25.8 ± 2.8 cm/年）与正常婴儿（25.5 ± 0.75 cm/年）相似。在最初的6年里，所有CH儿童的身高生长与疾病控制和预防中心（CDC）的数据相比是正常的。CH儿童的平均身高标准差评分（HtSDS）仅在出生后第二年显示出向其父母中等身高SDS（MPHtSDS）的调整（± 0.5 SD）。儿童的平均HtSDS在2岁至7岁之间平均高出0.4 SD。这些数据证明，有效的筛查和治疗完全保证了CH患者的正常神经发育和线性生长。数据显示，他们的HtSDS在儿童时期略高于他们的MPHtSDS。
Different growth and neuro-developmental outcomes have been associated with different doses of thyroxine given to infants with congenital hypothyroidism (CH). We studied the longitudinal growth pattern and assessed the neurodevelopment of 45 children with CH(25 girls, 20 boys) diagnosed through the national screening program in Qatar, for 6 years or more to examine the effects of initial T4 dosage (50 μg/day) with adjustment of T4 dose to maintain serum free T4 concentrations within the upper quartile of normal range and thyroid stimulating hormone < 4 mIU/mLThe birth size of newborns with CH diagnosed through the screening program before January 2003, was recorded and their growth in weight and stature was monitored every 3 months for at least 6 years of life. The IQ of children was assessed between 3 and 6 years of age using The Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III). Birth weight, length, and head circumference of patients (3.21 ± 0.43 kg, 50.5 ± 3.21 cm and 34.1 ± 1.5 cm, respectively) did not differ than those for 10,560 normal newborns with normal thyroid function (3.19 ± 0.59 kg, 50.5 ± 2.2 cm and 34.2 ± 1.7 cm). During the first year CH children growth (25.8 ± 2.8 cm/year) was similar to those for normal infants (25.5 ± 0.75 cm/year). During the first 6 years, stature growth was normal in all children with CH versus Center for disease control and prevention (CDC) data. The mean height standard deviation score (HtSDS) of children with CH showed adjustment (± 0.5 SD) toward their mid-parental height SDS (MPHtSDS) only during the second year of life. The children's mean HtSDS was higher by an average of 0.4 SD between the 2nd and 7th year of life. These data proved that effective screening and treatment completely assures normal neurodevelopment and linear growth in patients with CH. The data showed that their HtSDS slightly exceeds their MPHtSDS during childhood.