100例先天性甲状腺功能减退症患儿治疗前后的生长随访。

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

摘要

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