Komur Mustafa, Ozen Samim, Okuyaz Cetin, Makharoblıdze Khatuna, Erdogan Semra
Department of Pediatric Neurology, Mersin University School of Medicine, Mersin, Turkey.
Brain Dev. 2013 May;35(5):392-7. doi: 10.1016/j.braindev.2012.07.003. Epub 2012 Jul 31.
Congenital hypothyroidism is the most common reason of mental retardation, and normal neurological development can be provided by early and effective treatment. In this present study, it is aimed to compare neurological developments of patients in 6-42 months of age with congenital hypothyroidism and healthy controls of the same age group prospectively by Bayley III test.
In this present study, neurological developments of 41 congenital hypothyroidism cases and 39 healthy controls, who applied to Pediatric Endocrinology Section of Mersin Children Hospital and Pediatric Neurology Outpatient Clinic of the Medical School at Mersin University between years 2009 and 2011, were evaluated by Bayley III test.
Cognitive, language and global motor scores in addition to receptive communication, expressive communication, fine motor and gross motor subscores in children with congenital hypothyroidism were statistically significantly lower than those in the control group (p<0.05). It is detected that initiation dose and day of treatments, severity of hypothyroidism and time to normalization thyroid stimulating hormone had no statistically significant effects on neurological development of the study group (p>0.05). In both groups, as the education levels of mothers are increased, language development scores are also increased (p<0.05). Additionally, statistically significant increases in Bayley III scores except cognitive scores have been observed in both groups as the level of income is increased (p<0.05).
Despite early and effective treatment in newborns with congenital hypothyroidism, retardation in neurological developmental has been detected. This situation can be related to influences on neurodevelopment in intrauterine period. According to our present knowledge, this study is the first case-control study in the literature that neurological developments of congenital hypothyroidism patients are evaluated with Bayley-III score.
先天性甲状腺功能减退症是智力发育迟缓最常见的原因,早期有效治疗可确保正常的神经发育。本研究旨在通过贝利婴幼儿发展量表第三版(Bayley III)对6至42个月大的先天性甲状腺功能减退症患儿和同年龄组健康对照者的神经发育情况进行前瞻性比较。
本研究中,对2009年至2011年间在梅尔辛儿童医院儿科内分泌科和梅尔辛大学医学院儿科神经门诊就诊的41例先天性甲状腺功能减退症患儿及39名健康对照者,采用贝利婴幼儿发展量表第三版进行神经发育评估。
先天性甲状腺功能减退症患儿的认知、语言和总体运动得分,以及接受性沟通、表达性沟通、精细运动和大运动子得分在统计学上均显著低于对照组(p<0.05)。研究发现,起始治疗剂量和治疗时间、甲状腺功能减退症的严重程度以及促甲状腺激素恢复正常的时间对研究组的神经发育无统计学显著影响(p>0.05)。在两组中,随着母亲教育水平的提高,语言发育得分也随之增加(p<0.05)。此外,两组中随着收入水平的提高,除认知得分外,贝利婴幼儿发展量表第三版得分在统计学上均显著增加(p<0.05)。
尽管对先天性甲状腺功能减退症新生儿进行了早期有效治疗,但仍发现其神经发育迟缓。这种情况可能与宫内期对神经发育的影响有关。据我们目前所知,本研究是文献中首例使用贝利婴幼儿发展量表第三版评分评估先天性甲状腺功能减退症患者神经发育情况的病例对照研究。