EFFECT OF TREATMENT OF INFANTS WITH BORDER-LINE CONGENITAL HYPOTHYROIDISM ON THEIR LATER THYROID FUNCTIONS

在大鼠实验中，先天性甲状腺功能减退症（CH）大鼠在9个月龄时测定其血清TSH和游离甲状腺素（FT 4）水平。结果表明，两组甲状腺功能均在正常范围内，提示甲状腺功能正常。13例临界CH新生儿（血TSH值为20.75±21.32μIU/l）用1-甲状腺素（LT_4）（5 μg/kg体重/d）治疗，直到18.8±14.4月龄停止LT_4治疗，其甲状腺激素水平保持在正常范围内。在停止LT 4治疗后12.2±12.4个月测量其甲状腺激素水平：TSH，2.99±1.66μIU/l ; FT 4，2.34 ±2.97μg/dl，均在正常范围内。这表明，早期治疗边缘CH新生儿与LT 4不干扰甲状腺功能。（Asami T等人，Acta Paediatr，2004）。在另一项研究中，我们发现CH的发病具有季节性，2月发病率最高，5月发病率最低。日 ...更多信息 冬季CH患者数最多。环境中化合物的季节性变化可能在季节性中起一定作用（Nakamizo M，Asami T，et al. JPaediatrChildHealth，2005））。为探讨CH患儿治疗前临床表现与其发育商（DQ）的关系，将129例CH患儿按智力表现分为良好组和不良组。CH儿童的智力结果往往与正常儿童相似。然而，低出生体重、并发症的存在和高血清TSH值是DQ评分始终小于100的不利病例的风险因素（Nakamizo M，Asami T，et al. Clinical Pediatrics，2006 in press）。最后，我们阐明了早期治疗CH患者的长期后果。在109名筛查发现的CH患者中，63人现在就读小学，28人就读初中，6人就读高中，1人就读职业学校，3人就读大学。在其余的病人中，一名是有两个孩子的家庭主妇，七名在不同的公司工作。从这些结果可以得出结论，早期治疗的边缘线CH新生儿与LT 4没有有害的影响，在以后的生活中的甲状腺功能。我强烈推荐这种早期治疗的边缘线CH婴儿。少

In rat experiments, congenital hypothyroidism (CH) rats were measured for their serum TSH and free thyroxine (FT4) levels at the age of 9 months. The values were all within normal ranges, which suggested their thyroid functions were normalized. Thirteen border-line CH neonates (blood TSH values, 20.75±21.32μIU/l) were treated with 1-thyroxine (LT4) (5 μg/kg of body weight/day) and their thyroid hormone levels were kept within normal ranges up to the cessation of the LT4 treatment at the ages of 18.8±14.4 months. Their thyroid hormone levels were measured 12.2±12.4 months after the cessation of LT4 treatment : TSH, 2.99±1.66μIU/l ; and FT4,2.34±2.97μg/dl, which were all within normal ranges. This showed that the early treatment of border-line CH neonates with LT4 do not disturb thyroid functions. (Asami T, et al. Acta Paediatr, 2004). In another study, we found the seasonality in the incidence of CH that the highest incidence of CH was in February and the lowest incidence was in May. Th … More e number of CH patients in winter was the largest among the four seasons. seasonal variation of chemical compounds in the environment may play some role in the seasonality (Nakamizo M, Asami T, et al. J Paediatr Child Health, 2005)). In order to assess the relationship between the clinical findings before starting treatment and the development quotient (DQ) in children treated foe CH. 129 CH patients were divided into favorable and unfavorable groups according to intellectual performance. CH children tend to have a similar intellectual outcome to those of normal children. However, a low birth weight, the presence of complications and a high serum TSH value are the risk factors for unfavorable cases who consistently have a DQ score of less than 100 (Nakamizo M, Asami T, et al. Clinical Pediatrics, 2006 in press). Finally, we clarified the long-term consequences of early-treated CH patients. Of the 109 screening-detected CH patients, 63 are now attending primary schools, 28,junior high schools, six, senior high schools, one, job-oriented school, and three, university. Of the remaining patients, one is a house wife having two children, and seven are working at various companies. From these results it is concluded that the early treatment of border-line CH neonates with LT4 do not have harmful effect on thyroid functions in later life. I strongly recommend this early treatment of border-line CH infants.. Less