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[先天性甲状腺功能减退症患者谨慎治疗后的神经精神结局:托斯卡纳一组患者的危险因素分析]

[Neuropsychiatric outcome in patients with congenital hypothyroidism precautiously treated: Risk factors analysis in a group of patients from Tuscany].

作者信息

Bargagna S, Astrea G, Perelli V, Rafanelli V

机构信息

Istituto Scientifico di Neuropsichiatria e Psicopedagogia dell'Età Evolutiva, IRCCS Stella Maris, Calambrone, Pisa, Italy.

出版信息

Minerva Pediatr. 2006 Jun;58(3):279-87.

Abstract

AIM

In order to avoid an excessive medical monitoring and to obtain more functional medical controls for the outcome of children with early treated congenital hypothyroidism, the results of a neurological and psychiatric follow-up performed in area Pisana since 1990 are revised. This analysis gives some indications to get over the differences of the various methodological approaches and to get better rehabilitation treatment in respect to the individual needs.

METHODS

Our study group includes 52 children with early treated congenital hypothyroidism; a semiquantitative score was used to assess sociocultural level (SCL) of the family. Cognitive and language performances were evaluated by Griffiths Mental Development Scale and with Wechsler Intelligence Scale for Children (WISC-R).

RESULTS

Study group mean total scores in cognitive tests are within the normal range, motor and language impairments have been noted, instead. These skills are significantly correlated with pretreatment serum thyroxine (T4). In addition a low SCL is a great risk factor for the occurrence of mild impairments in neuropsychological development.

CONCLUSIONS

In arranging the neuropsychological follow-up in early treated congenital hypothyroidism it is recommended to keep in mind the importance of the combination of neonatal endocrinological factors (in particular, pretreatment serum thyroxine) and SCL on the cognitive, motor and language development.

摘要

目的

为避免过度的医学监测,并为早期治疗的先天性甲状腺功能减退症患儿的预后获得更多功能性医学控制,对自1990年以来在比萨纳地区进行的神经和精神科随访结果进行了修订。该分析给出了一些指示,以克服各种方法学方法的差异,并根据个体需求获得更好的康复治疗。

方法

我们的研究组包括52例早期治疗的先天性甲状腺功能减退症患儿;使用半定量评分来评估家庭的社会文化水平(SCL)。认知和语言表现通过格里菲斯心理发展量表和韦氏儿童智力量表(WISC-R)进行评估。

结果

研究组在认知测试中的平均总分在正常范围内,相反,已注意到运动和语言障碍。这些技能与治疗前血清甲状腺素(T4)显著相关。此外,低社会文化水平是神经心理发展出现轻度障碍的一个重大危险因素。

结论

在安排早期治疗的先天性甲状腺功能减退症的神经心理随访时,建议牢记新生儿内分泌因素(特别是治疗前血清甲状腺素)和社会文化水平对认知、运动和语言发展的综合重要性。

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