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

边缘性先天性甲状腺功能减退症婴儿的治疗对其后期甲状腺功能的影响

基本信息

批准号：
15591093
负责人：
ASAMI Tadashi
金额：
$ 1.22万
依托单位：
NIIGATA SEIRYO UNIVERSITY (2005)Niigata University (2003-2004)
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2005
项目状态：
已结题

项目摘要

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

在大鼠实验中，我们测量了先天性甲状腺功能减退（CH）大鼠在9月龄时的血清TSH和游离甲状腺素（FT4）水平。结果均在正常范围内，说明甲状腺功能正常。采用5 μg/kg体重/天的1-甲状腺素（LT4）治疗13例边缘型CH新生儿（血TSH值为20.75±21.32μIU/l），直到18.8±14.4月龄LT4治疗停止，其甲状腺激素水平保持在正常范围内。在LT4治疗停止后12.2±12.4个月测定甲状腺激素水平：TSH， 2.99±1.66μIU/l；FT4为2.34±2.97μg/dl，均在正常范围内。这表明LT4边缘型CH新生儿的早期治疗不会影响甲状腺功能。(Asami T，等。儿科学报，2004年)。在另一项研究中，我们发现了CH发病率的季节性，2月份发病率最高，5月份发病率最低。4个季节中，以冬季发病最多。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.）。[儿科和儿童保健]，2005年)。为了评价治疗前临床表现与发展商（DQ）之间的关系，将129例患儿根据智力表现分为有利组和不利组。CH儿童往往具有与正常儿童相似的智力结果。然而，低出生体重、并发症的存在和高血清TSH值是持续DQ评分低于100的不利病例的危险因素（Nakamizo M, Asami T, et al.）。临床儿科学，2006年出版)。最后，我们澄清了早期治疗CH患者的长期后果。在109例筛查出的CH患者中，小学63人，初中28人，高中6人，就业学校1人，大学3人。剩下的患者中，有1人是有两个孩子的家庭主妇，7人在不同的公司工作。从这些结果可以得出结论，早期治疗边缘性CH新生儿LT4不会对以后的甲状腺功能产生有害影响。我强烈建议对边界线婴儿进行早期治疗。少