先天性甲状腺功能减低症患儿治疗转归及相关因素研究

目的 分析影响先天性甲状腺功能减低症(congenital hypothyroidism，CH)患儿治疗转归的相关因素，为判断治疗转归提供依据。方法 对规范治疗后424例先天性CH患儿治疗转归的可能相关因素进行回顾性分析总结。采用Logistic多元回归分析影响先天性CH患儿治疗转归的相关因素。结果 相关因素中，甲状腺彩超异常(提示甲状腺发育异常)组有显著意义，两组间差异有统计学意义(P<0.01) ，性别组、是否并发缺血缺氧性脑病组、高胆红素血症组、确诊时促甲状腺素异常值的高低组，相应两组间差异均无统计学意义(P>0.05) 。结论 先天性CH患儿治疗转归与出生时甲状腺发育异常有关，而与性别、出生时是否并发缺血缺氧性脑病、高胆红素血症、确诊时促甲状腺素异常的高低均无关系。出生时甲状腺彩超有助预示治疗后的转归。

Study on the treatment outcome and its related factors of children with congenital hypothyroidism

Objective To analyse the related factors of influence to children with congenital hypothyroidism (CH) after treatment outcome,and to provide the basis for judging treatment outcome. Methods By grouping comparison,in the statistical chi-square analysis,to retrospectively analyse and summarize the possible related factors of 424 cases of children with CH after standard treatment.To analyse the related factors of influence to children with CH after treatment outcome using Logistic multivariate regression analysis. Results There were statistically significant differences between the two groups of the abnormal thyroid after color Doppler ultrasound checked (suggest thyroid dysplasia)(P<0.01),no significant differences was found among gender groups,the groups whether concurrent hypoxic-ischemic encephalopathy (HIE),the high blood bilirubin groups,and the groups of thyroid-stimulating hormone (TSH) outliers when confirmed,the differences between the corresponding two groups were not statistically significant (P>0.05). Conclusion It is found that the treatment outcome for children with CH should be concerned with thyroid dysplasia at birth,and shouldn't be concerned with gender,HIE,high blood bilirubin at birth and the outliers of TSH when confirmed.Color Doppler ultrasound checked for thyroid at born can help to predict the outcome after treatment.