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

在大鼠实验中，测定了9月龄先天性甲状腺功能减退症(CH)大鼠的血清TSH和游离甲状腺素(FT4)水平。这些值均在正常范围内，表明他们的甲状腺功能已恢复正常。13例临界CH新生儿(血TSH值20.75±21.32μIU/L)用1-甲状腺素(5μg/kg/d)治疗，至停药前甲状腺激素水平维持在正常范围。停药后12.2±12.4个月测定甲状腺激素水平：促甲状腺激素2.99±1.6 6μIU/L，FT4 2.34±2.97μg/dl，均在正常范围内。提示早期应用LT4治疗临界性CH新生儿不会对甲状腺功能产生影响。(Asami T，et al.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，CH发病率最高的月份是2月份，最低的发病率是5月份。TH…4个季节中冬季发病人数最多。环境中化合物的季节性变化可能对季节性起到一定作用(Nakamizo M，Asami T等人)。儿童健康杂志，2005年))。目的：探讨脑出血患儿治疗前的临床表现与发育商(DQ)的关系。根据智力表现将129例脑出血患者分为有利组和不利组。CH儿童的智力结果往往与正常儿童相似。然而，低出生体重、存在并发症和高血清TSH值是DQ持续低于100的不利病例的危险因素(Nakamizo M，Asami T等人)。《临床儿科》，2006年出版)。最后，我们阐明了早期治疗的CH患者的长期后果。在109名筛查发现的CH患者中，63人目前在上小学，28人在初中，6人在高中，1人在就业导向的学校，3人在大学。在剩下的患者中，一名是有两个孩子的家庭主妇，七名在不同的公司工作。这些结果表明，早期应用LT4治疗临界CH新生儿对以后的甲状腺功能无不良影响。我强烈建议对临界性先天性心脏病婴儿进行早期治疗。较少

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