Growth follow-up in 100 children with congenital hypothyroidism before and during treatment.

A Chiesa, L Gruñeiro de Papendieck, A Keselman, J J Heinrich, C Bergada
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引用次数: 33

Abstract

In order to assess the influence of age at onset of treatment on subsequent growth, height, weight, head circumference (HC) and bone age as estimated by Greulich-Pyle and TW2-RUS methods, 100 children with congenital hypothyroidism (CH) were studied before and during adequate treatment up to 5 years of age. The patients were divided into five groups according to age at the start of treatment: Group 1: < 2 months (n = 26); Group 2: 2-3 months (n = 13); Group 3: 3-6 months (n = 21); Group 4: 6-12 months (n = 20); Group 5: 12-24 months (n = 20). Before treatment, groups 1 and 2 differed significantly from the others in height (p < 0.001). With hormone therapy, catch-up growth was observed in groups 3 to 5, but at age 5 years no differences were found between groups. In all groups, height at 5 years of age correlated significantly with children's midparental height (p < 0.002). Bone age was initially retarded in groups 3 to 5, but approximated the chronological age by age 5 years. Initially, HC was less affected than height and remained relatively larger up to age 5 years in all groups. These findings show that thyroid hormone replacement in CH as late as 24 months corrects the short stature and delayed bone age by age 5 years.
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100例先天性甲状腺功能减退症患儿治疗前后的生长随访。
为了评估治疗年龄对随后的生长、身高、体重、头围(HC)和骨龄(Greulich-Pyle法和TW2-RUS法)的影响,研究了100名先天性甲状腺功能减退症(CH)患儿在治疗前和治疗期间(5岁前)的情况。根据患者开始治疗时的年龄分为5组:1组< 2个月(n = 26);第二组:2-3个月(n = 13);第三组:3 ~ 6个月(n = 21);第4组:6-12个月(n = 20);第5组:12-24个月(n = 20)。治疗前,1、2组患者身高差异有统计学意义(p < 0.001)。通过激素治疗,在第3至第5组观察到追赶生长,但在5岁时各组之间没有发现差异。各组儿童5岁身高与双亲身高均显著相关(p < 0.002)。骨龄在第3至第5组开始减慢,但在5岁时接近实足年龄。最初,HC受身高影响较小,并且在所有组中一直保持相对较大,直到5岁。这些研究结果表明,甲状腺激素替代治疗迟至24个月的CH可纠正身高矮小和延迟5岁的骨龄。
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