Department of Pediatrics, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Endocr J. 2011;58(5):355-61. doi: 10.1507/endocrj.k10e-384. Epub 2011 Apr 5.
Neurodevelopment in children with congenital hypothyroidism who receive early treatment is generally good. However, subtle neurological deficits still exist in some patients. The aim of this investigation was to evaluate factors that may influence neurodevelopmental outcome in congenital hypothyroidism patients. The developmental quotient (DQ) of 155 children with congenital hypothyroidism was evaluated at 24 months of age, using Gesell Developmental Schedules (GDS), and compared with that of 310 healthy controls. Mean DQ scores in congenital hypothyroidism patients were 7.5 points lower for adaptive behavior than in control patients (p < 0.01). Patients with severe congenital hypothyroidism had the lowest DQ scores compared with two other congenital hypothyroidism subgroups and controls (p < 0.01). Children with congenital hypothyroidism who also had a low level of serum T(4) at diagnosis or exhibited a longer thyroid stimulating hormone (TSH) normalization time had lower adaptive behavior scores (p < 0.0003). Bivariate correlation and multiple regression analyses found that the severity of congenital hypothyroidism and parental socioeconomic status correlated with DQ scores. TSH normalization time was negatively related to adaptive behavior scores (p < 0.01). Neurodevelopmental deficits in children with congenital hypothyroidism correlate with the severity of congenital hypothyroidism, TSH normalization time, and parental socioeconomic status.
儿童先天性甲状腺功能减退症接受早期治疗后的神经发育通常较好。然而，一些患者仍存在细微的神经缺陷。本研究旨在评估可能影响先天性甲状腺功能减退症患者神经发育结局的因素。使用 Gesell 发育量表（GDS）评估了 155 例先天性甲状腺功能减退症患儿在 24 个月时的发育商（DQ），并与 310 例健康对照组进行比较。与对照组相比，先天性甲状腺功能减退症患儿的适应性行为平均 DQ 评分低 7.5 分（p<0.01）。与其他两个先天性甲状腺功能减退症亚组和对照组相比，严重先天性甲状腺功能减退症患儿的 DQ 评分最低（p<0.01）。诊断时血清 T4 水平较低或 TSH 正常化时间较长的先天性甲状腺功能减退症患儿的适应性行为评分较低（p<0.0003）。双变量相关和多元回归分析发现，先天性甲状腺功能减退症的严重程度和父母的社会经济地位与 DQ 评分相关。TSH 正常化时间与适应性行为评分呈负相关（p<0.01）。先天性甲状腺功能减退症患儿的神经发育缺陷与先天性甲状腺功能减退症的严重程度、TSH 正常化时间和父母的社会经济地位有关。
