临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (12): 1116-.doi: 10.3969 j.issn.1000-3606.2014.12.004

• 内分泌遗传代谢性疾病专栏 • 上一篇    下一篇

新生儿高促甲状腺激素血症临床转归分析

武万良1,2,潘建平1,李风侠2   

  1. 1. 西安交通大学医学院( 陕西西安 710054);2. 陕西省妇幼保健院( 陕西西安 710003)
  • 收稿日期:2014-12-15 出版日期:2014-12-15 发布日期:2014-12-15

The prognosis of neonatal hyperthyrotropinemia

 WU Wanliang 1,2, PAN Jianping1, LI Fengxia2   

  1. 1.Department of Public Health, Medical College of Xi’an Jiaotong University, Xi’an 710054, Shannxi, China; 2.Shannxi Maternal and Child Care Service Centre, Xi’an 710003, Shannxi, China
  • Received:2014-12-15 Online:2014-12-15 Published:2014-12-15

摘要: 目的 探讨新生儿高促甲状腺素血症(HT)的临床转归。方法 定期随访高促甲状腺激素(TSH)血症患儿,评估其生长发育指标和甲状腺功能及治疗效果。结果 新生儿筛查血清TSH 5.6~10 mU/L的191例患儿随访至24个月;182例血TSH逐渐恢复正常,5例血TSH逐渐升高>10 mU/L,予以左甲状腺素钠治疗,4例随访2年后血TSH值仍波动在5.6~10 mU/L,继续随访中;血清TSH在10~20 mU/L的44例患儿,予以左甲状腺素钠治疗后38例血TSH值逐渐恢复正常;7例血TSH>20 mU/L患儿需持续左甲状腺素钠治疗。242例HT新生儿中共有18例持续服用左甲状腺素钠替代治疗2年,继续随访。结论 大多数新生儿HT随年龄增长逐渐恢复正常,有少部分患儿出现甲状腺功能异常,应积极随访。

Abstract: Objective To study the prognosis of neonatal hyperthyrotropinemia (HT). Methods Children with HT were followed up regularly to evaluate the growth index, thyroid function and effectiveness of treatment. Results One hundred and ninety-one neonates with serum TSH level of 5.6~10 mU/L at the screening were followed up until 24 months old. Serum TSH gradually returned to normal range in 182 cases. Serum TSH increased to be >10 mU/L in 5 cases who were treated with levothyroxine sodium. Serum TSH fluctuated between 5.6 and 10 mU/L in 4 cases who were continually followed up. Among 44 cases of serum TSH at 10~20mU/L, serum TSH gradually returned to normal range after levothyroxine sodium treatment in 38 cases; serum TSH increased to >20 mU/L in 7 cases for whom continuous treatment with levothyroxine sodium was required. In 242 cases of HT neonates, 18 cases had received continuous levothyroxine sodium replacement treatment for 2 years and were followed-up continuously. Conclusions Most of the newborns with HT recover within 2 years, while a few develop thyroid dysfunction and require follow-ups.