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亚临床甲状腺功能减退症患儿及青少年的神经认知功能

Neurocognitive functions in children and adolescents with subclinical hypothyroidism.

作者信息

Ergür Ayça Törel, Taner Yasemen, Ata Evşen, Melek Efnan, Bakar Emel Erdoğan, Sancak Tanzer

机构信息

Ufuk University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey.

出版信息

J Clin Res Pediatr Endocrinol. 2012 Mar;4(1):21-4. doi: 10.4274/Jcrpe.497.

Abstract

OBJECTIVE

Hypothyroidism is a metabolic condition that can lead to cognitive and behavioral deficits in children and adolescents. However, there is less evidence about subclinical hypothyroidism (SH) as a risk factor for neuropsychological disorders in childhood. The aim of this study was to evaluate cognitive functions like active/passive attention, maintaining attention, and response inhibition in pediatric patients with SH.

METHODS

Seventeen patients (between 7-17 years old) with SH were tested with the Stroop test, Verbal Fluency test and the sub-tests of the Wechsler intelligence scale for children-Revised (WISC-R). SH diagnosis was based on the mild increase of serum thyrotropin (TSH) level together with a normal serum free thyroxine level and an exaggerated TSH response to thyrotropin-releasing hormone.

RESULTS

Out of seventeen cases, 10 (59%) were girls and 7 (41%) were boys. Six cases were obese and 5 were overweight. The children in the SH group, as compared to the control group, obtained significantly lower scores on both the Digit Span subtest of the WISC-R and the Stroop subtests, which are sensitive to attention. No significant differences were found between the SH group and the healthy controls in verbal fluency and encoding tests.

CONCLUSION

In this study, pediatric patients with SH showed poor performance in tests measuring attention. Therefore, we want to stress the importance of close collaboration between pediatric endocrinology and child and adolescent psychiatry departments.

摘要

目的

甲状腺功能减退是一种代谢性疾病,可导致儿童和青少年出现认知和行为缺陷。然而,关于亚临床甲状腺功能减退(SH)作为儿童神经心理障碍危险因素的证据较少。本研究的目的是评估患有SH的儿科患者的主动/被动注意力、维持注意力和反应抑制等认知功能。

方法

对17例年龄在7至17岁之间的SH患者进行了斯特鲁普测试、语言流畅性测试以及韦氏儿童智力量表修订版(WISC-R)的子测试。SH的诊断基于血清促甲状腺激素(TSH)水平轻度升高,同时血清游离甲状腺素水平正常,以及对促甲状腺激素释放激素的TSH反应过度。

结果

17例患者中,10例(59%)为女孩,7例(41%)为男孩。6例肥胖,5例超重。与对照组相比,SH组儿童在对注意力敏感的WISC-R数字广度子测试和斯特鲁普子测试中的得分显著更低。在语言流畅性和编码测试中,SH组与健康对照组之间未发现显著差异。

结论

在本研究中,患有SH的儿科患者在注意力测试中表现不佳。因此,我们想强调儿科内分泌科与儿童和青少年精神科密切合作的重要性。

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