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对1至13岁重型β地中海贫血患儿甲状腺功能的评估。

Assessment of thyroid function in children aged 1-13 years with Beta-thalassemia major.

作者信息

Pirinççioğlu Ayfer Gözü, Deniz Turgay, Gökalp Deniz, Beyazit Nurcan, Haspolat Kenan, Söker Murat

机构信息

Department of Pediatrics, Faculty of Medicine, University of Dicle, Diyarbakir, Turkey.

出版信息

Iran J Pediatr. 2011 Mar;21(1):77-82.

Abstract

OBJECTIVE

Hypothyroidism usually appears in the second decade of life and is thought to be associated with iron overload in patients with thalassemia major. This study aimed to evaluate thyroid dysfunctions in patients with beta-thalassemia major and to see if they appear in the earlier period of life.

METHODS

Thyroid function and iron load status were evaluated in 90 children with a mean age of 7.17±3.78 years with beta-thalassemia major by measuring serum free thyroxin (FT4), serum free triiodothyronine (FT3), total thyroxin (T3), serum total triiodothyronine (T4), thyroid-stimulating hormone (TSH) and ferritin levels from serum of patients admitted to the Pediatric Department, Faculty of Medicine University of Dicle between March 2005 and July 2009. A control group formed from an age-sex matched healthy children with a mean age of 6.98±3.66 years was also included. A standard thyrotropin releasing hormone test was applied to 3 patients who had high TSH levels and were classified as subclinical primer hypothyroidism. The study was designed according to the Declaration of Helsinki and informed consent was obtained from the parents of all participants.

FINDINGS

All thyroid parameters in patients were in the normal ranges compared with the controls except three of them which had high TSH levels. Serum ferritin level (2703±1649 ng/mL) in patients was significantly higher than in controls (81.5±15.5 ng/mL).

CONCLUSION

The work implies that hypothyroidism could be even seen in the first decade of life in patients with beta-thalassemia major in spite of improved hematological cares.

摘要

目的

甲状腺功能减退通常出现在生命的第二个十年,被认为与重型地中海贫血患者的铁过载有关。本研究旨在评估重型β地中海贫血患者的甲状腺功能障碍,并观察其是否出现在生命的早期阶段。

方法

2005年3月至2009年7月期间,对90名平均年龄为7.17±3.78岁的重型β地中海贫血儿童进行甲状腺功能和铁负荷状态评估,通过检测其血清游离甲状腺素(FT4)、血清游离三碘甲状腺原氨酸(FT3)、总甲状腺素(T3)、血清总三碘甲状腺原氨酸(T4)、促甲状腺激素(TSH)和铁蛋白水平。还纳入了一个由平均年龄为6.98±3.66岁的年龄和性别匹配的健康儿童组成的对照组。对3名TSH水平高且被归类为亚临床原发性甲状腺功能减退的患者进行了标准促甲状腺激素释放激素试验。该研究是根据《赫尔辛基宣言》设计的,并获得了所有参与者父母的知情同意。

结果

与对照组相比,患者的所有甲状腺参数均在正常范围内,但其中3名患者的TSH水平较高。患者的血清铁蛋白水平(2703±1649 ng/mL)显著高于对照组(81.5±15.5 ng/mL)。

结论

这项研究表明,尽管血液学护理有所改善,但重型β地中海贫血患者在生命的第一个十年甚至可能出现甲状腺功能减退。

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