摘要
目的:探讨用小剂量左甲状腺素钠片治疗新生儿高促甲状腺激素血症(HT)的效果。方法:选择榆林市儿童医院2019年5月至2020年5月期间收治的128例新生儿HT患儿作为研究对象。根据是否接受药物治疗将其分为对照组和观察组。观察组患儿采用小剂量左甲状腺素钠片进行治疗,对照组患儿未接受药物治疗,只对其进行常规的随访观察。比较两组患儿甲状腺激素的水平、临床症状和体征的出现情况、身高、体重及智力发育水平。结果:出生6个月后,两组患儿血清TSH的水平均低于出生时,其血清FT4的水平均高于出生时,差异有统计学意义(P<0.05)。出生6个月后,观察组患儿血清FT4的水平高于对照组患儿,差异有统计学意义(P<0.05);两组患儿血清TSH的水平相比,差异无统计学意义(P>0.05)。出生1年后,观察组患儿临床症状和体征的出现率低于对照组患儿,差异有统计学意义(P<0.05)。出生1年后,两组患儿的身高、体重相比,差异无统计学意义(P>0.05);观察组患儿的发育商高于对照组患儿,差异有统计学意义(P<0.05)。结论:用小剂量左甲状腺素钠片治疗新生儿HT的效果显著,能有效改善患儿甲状腺激素的水平,预防其出现喂养困难、腹胀、全身黏液性水肿伴特殊面容等临床表现,且能促进其智力的发育。
Objective:To investigate the effect of low-dose levothyroxine sodium tablets in the treatment of neonatal hyperthyrotropin(HT).Methods:A total of 128 neonates with HT admitted to Yulin Children's Hospital from May 2019 to May 2020 were selected as the research objects.They were divided into control group and observation group according to whether they received drug treatment.The children in the observation group were treated with low-dose levothyroxine sodium tablets,while the children in the control group received no drug treatment and were only followed up for routine observation.The levels of thyroid hormone,clinical symptoms and signs,height,weight and mental development were compared between the two groups.Results:After 6 months of birth,the serum TSH levels of the two groups were lower than those at birth,and the serum FT4 levels were higher than those at birth,and the differences were statistically significant(P<0.05).After 6 months of birth,the serum FT4 level in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in serum TSH levels between the two groups(P>0.05).One year after birth,the occurrence rate of clinical symptoms and signs in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).One year after birth,there was no significant difference in height and weight between the two groups(P>0.05).The development quotient of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Low dose levothyroxine sodium tablet has a significant effect in the treatment of neonatal HT,which can effectively improve the level of thyroid hormone in children,prevent the clinical manifestations such as feeding difficulties,abdominal distension,systemic myxoedema with special facial features,and promote the development of intelligence.
作者
祝玉平
ZHU Yuping(Yulin Yuyang District People's Hospital,Yulin Children's Hospital,Yuli n shaanxi 719000)
