Gibert Agulló Anna, Vicens-Calvet Enric, Carrascosa Lezcano Antonio, Bargadá Esteve María, Potau Vilalta Neus
Servicio de Pediatría y Endocrinología Pediátrica, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
Med Clin (Barc). 2010 Mar 13;134(7):287-95. doi: 10.1016/j.medcli.2009.07.048. Epub 2009 Nov 18.
Many countries have developed screening programs for CH that bring about a normal somatic and psychological development. The aim of this study is to evaluate the evolution of cases detected by the screening program of congenital hypothyroidism in Catalonia.
The was a descriptive, longitudinal study of a series of 136 cases of congenital hypothyroidism detected by the screening program in Catalonia from 1986 to 1997 and who had been checked in the Maternal-infantile Vall d'Hebron Hospital in Barcelona. Follow-up was carried out for growth and a psychological exploration was performed (McCarthy test and WISC-R).
Males (30 cases, 22.1%) and females (106 cases, 77.9%) with congenital hypothyroidism of this study had a height, weight and BMI that were not different from those of the current population of Barcelona. Height was 0.5 SD above the Tanner reference values of 1966 and BMI was one SD above the Roland-Cachera reference values of 1982. This secular acceleration of growth has been observed in all developed countries. In a sample of 37.5% of the cases, psychological development did not differ from that of the reference population. However, a greater intensity of neonatal hypothyroidism and its most delayed normalization correlated negatively with the score in the psychological tests.
Once normalization of growth and psychological development are achieved, the screening program of congenital hypothyroidism in Catalonia should be optimized by initiating treatment as soon as possible to avoid the possibility that some children do not reach their complete intellectual potential.
许多国家已开展先天性甲状腺功能减退症（CH）筛查项目，以实现正常的躯体和心理发育。本研究旨在评估加泰罗尼亚先天性甲状腺功能减退症筛查项目所检测病例的发展情况。
这是一项描述性纵向研究，对1986年至1997年加泰罗尼亚筛查项目检测出的136例先天性甲状腺功能减退症病例进行研究，这些病例均在巴塞罗那的瓦尔德希伯伦母婴医院接受检查。对其生长情况进行随访，并进行心理评估（麦卡锡测验和韦氏儿童智力量表修订版）。
本研究中患先天性甲状腺功能减退症的男性（30例，22.1%）和女性（106例，77.9%）的身高、体重和体重指数与巴塞罗那当前人群并无差异。身高比1966年坦纳参考值高0.5个标准差，体重指数比1982年罗兰 - 卡切拉参考值高1个标准差。这种生长的长期加速现象在所有发达国家均有观察到。在37.5%的病例样本中，心理发育与参考人群无异。然而，新生儿甲状腺功能减退症的严重程度越高及其恢复正常的时间越晚，与心理测试得分呈负相关。
一旦实现生长和心理发育的正常化，加泰罗尼亚先天性甲状腺功能减退症筛查项目应通过尽早开始治疗进行优化，以避免一些儿童无法充分发挥其智力潜能的可能性。
