儿童亚临床甲状腺功能减退症15例临床分析

目的 通过15例亚临床甲状腺功能减退症临床分析,提高对此病的认识.方法 对江西省儿童医院2006年1月至今到内分泌门诊就诊的15例亚临床甲状腺功能减退症临床资料进行分析,15例均行甲状腺功能(FT3、T3、FT4、T4、TSH)测定、甲状腺彩超检查及甲状腺微粒体抗体(TMAb)、甲状腺球蛋白抗体(TGAb)测定.结果 15例亚临床甲状腺功能减退症均无明显甲状腺功能低下临床特征性表现,仅表现为轻微、非特异的症状,实验室检查示15例患儿FT3、T3、FT4、T4均正常,TSH升高,11例行TMAb、TGAb测定均正常,2例TMAb、TGAb均阳性,2例中TMAb阳性和TGAb阳性各一例,其中2例甲状腺彩超示轻度血流增加,3例甲状腺彩超示示甲状腺回声弥漫性降低,内部回声不均匀.结论 儿童亚临床甲状腺功能减退症无明显甲状腺功能低下临床特征性表现,FT3、T3、FT4、T4均正常,仅TSH升高.亚临床甲状腺功能减退症患儿临床表现很不典型,容易被患儿家长及临床医师忽视,在临床诊治过程中应提高对此病的认识,特别是对矮小、性早熟患儿常规行甲状腺功能测定.

Clinical Analysis for 15 Children with Subclinical Hypothyroidism

Objective To enhance the understanding of subclinical hypothyroidism,through analysis of 15 examples.Methods:clinical data of 15 subclinical hypothyroidism examples in the department of the endocrine outpatient in Jiangxi Province Children,s hospital from January,2006 to now were analyzed.Free triiodothyronine(FT3),triiodothyronine(T3),free(unbound)thyroxin(e)(FT4),thyroxine(T4),thyroidstimu1ating hormone(TSH),thyroid micro-somal antibody(TM-Ab),thyroglobulin antibody(TGAb)were determined and the thyroid gland was inspected by chromatic color type-B ultrasonic.Results Fifteen examples subclinical hypothyroidism were no obvious low thyroid function of clinical characteristic performance,only appeared a slight,non-special symptom.The results of FT3,T3,FT4,T4 of 15 examples were normal,but TSH was higher.And results of TMAb,TGAb of 11 examples were normal,and 2 examples showed positive,but TMAb of 1 example was positive,and TGAb was negative,and the rest one was just oppositive.Meanwhile,bloodstream of thyroid gland of 2 examples increased slightly,in 3 examples echo of thyroid gland reduced slowly and inner echo were uneven.Conclusion Children with subclinical hypothyroidism were no obvious low thyroid function of clinical characteristic performance.FT3,T3,FT4,T4 were all normal,only TSH were higher.Because it was easy to neglect by guardian and clinician,we should enhance the understanding of the disease in the clinical diagnosis process.Especially,thyroid function on dwarfishness or precocious puberty patient was determined.