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孕期服用甲巯咪唑的母亲所生儿童的甲状腺功能与智力发育

Thyroid function and intellectual development of children of mothers taking methimazole during pregnancy.

作者信息

Azizi F, Khamseh M E, Bahreynian M, Hedayati M

机构信息

The Endocrine Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, IR, Iran.

出版信息

J Endocrinol Invest. 2002 Jul-Aug;25(7):586-9. doi: 10.1007/BF03345080.

Abstract

There is some debate regarding the safety of methimazole (MMI) therapy during pregnancy. It is not known whether MMI therapy in mothers during pregnancy is safe for their children or if it causes alterations in thyroid function and intellectual development during childhood. Twenty-three children, whose mothers were hyperthyroid during pregnancy and treated with MMI 5-20 mg were studied from age 3-11 yr. Thyroid function and liver function tests, urinary iodine, anti-thyroid antibodies, intelligence quotient (IQ), verbal and functional components of Wechsler test were performed on 23 children of thyrotoxic mothers and 30 controls. In all children T3, T4, RT3U and TSH concentrations were normal. Mean T3, T4 and TSH values were 147 ng/dl, 9.7 microg/dl and 1.2 mU/l, respectively. Height, weight, thyroid function, and thyroid antibodies did not differ from controls. None of the children had T4 below 6 microg/dl or TSH>3.0 mU/l. Liver enzymes and serum albumin were normal in both groups. Mann-Whitney test showed no difference in verbal and performance IQ and their components between children of thyrotoxic mothers and controls. Total IQ of cases and controls was 117 +/- 11 and 113 +/- 14, respectively. No deleterious effect occurred in thyroid function and physical and intellectual development of children whose mothers were treated during pregnancy with doses of MMI up to 20 mg daily.

摘要

关于孕期使用甲巯咪唑(MMI)治疗的安全性存在一些争议。目前尚不清楚母亲在孕期接受MMI治疗对其子女是否安全,也不清楚这是否会导致儿童期甲状腺功能和智力发育的改变。对23名母亲在孕期患有甲亢且接受5 - 20毫克MMI治疗的儿童进行了研究,研究对象年龄在3至11岁之间。对23名甲亢母亲的子女和30名对照儿童进行了甲状腺功能和肝功能检查、尿碘、抗甲状腺抗体、智商(IQ)、韦氏测试的语言和功能成分检测。所有儿童的T3、T4、RT3U和TSH浓度均正常。T3、T4和TSH的平均数值分别为147纳克/分升、9.7微克/分升和1.2毫单位/升。身高、体重、甲状腺功能和甲状腺抗体与对照组无差异。没有儿童的T4低于6微克/分升或TSH>3.0毫单位/升。两组的肝酶和血清白蛋白均正常。曼 - 惠特尼检验显示,甲亢母亲的子女与对照组在语言和操作智商及其组成部分方面没有差异。病例组和对照组的总智商分别为117±11和113±14。母亲在孕期接受每日剂量高达20毫克MMI治疗的儿童,其甲状腺功能、身体和智力发育均未出现有害影响。

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