Ordooei Mahtab, Mottaghipisheh Hadi, Fallah Razieh, Rabiee Azar
Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ; Growth Disorders of Children Research Center, Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Iran J Child Neurol. 2014 Fall;8(4):28-32.
Early diagnosis and treatment of congenital hypothyroidism (CH) and the prevention of developmental retardation is the main goal of public health national screening programs. This study compares the cognitive ability of children with CH diagnosed by neonatal screening with a healthy control group (2007) in Yazd, Iran.
MATERIALS & METHODS: In a case-controlled study, the intelligent quotient (IQ) of 40 five-year-old children with early treated CH and good compliance were evaluated by the Wechsler preschool and primary scale of intelligent test and compared to 40 healthy age and gender matched children as controls.
22 boys (55%) and 18 girls (45%) in both groups were evaluated. In children with CH, 19 (47.5%) and 21 (52.5%) persons had transient and permanent hypothyroidism, respectively. Range of TSH and T4 level at the onset of diagnosis were 11.41-81 mu/l and 1.50-14.20 μg/dl, respectively. The intelligence levels of all children with CH were within the average or normal range and IQs ranged from 91-108. Children with CH had lower full-scale IQs (107.25 ± 2. 9 versus 110.50 ± 2.66, p=0.001), verbal IQ (106.95 ± 3.5 versus 109.90 ± 3.44, P-value=0.001) and performance IQ (106.3 ± 3.68 versus 108.87 ± 3.70) than the control group. However, no statistically significant differences were observed for mean IQ scores in permanent and transient CH.
Children with CH who had early treatment and good compliance had normal cognitive abilities, but may have a decreased IQ relative to the healthy control group.
先天性甲状腺功能减退症(CH)的早期诊断与治疗以及预防发育迟缓是国家公共卫生筛查项目的主要目标。本研究比较了伊朗亚兹德通过新生儿筛查诊断出的CH患儿与健康对照组(2007年)儿童的认知能力。
在一项病例对照研究中,采用韦氏学前和小学智力量表对40名早期接受治疗且依从性良好的五岁CH患儿的智商(IQ)进行评估,并与40名年龄和性别匹配的健康儿童作为对照进行比较。
两组中分别评估了22名男孩(55%)和18名女孩(45%)。在CH患儿中,分别有19名(47.5%)和21名(52.5%)患有暂时性和永久性甲状腺功能减退症。诊断开始时TSH和T4水平范围分别为11.41 - 81 μU/l和1.50 - 14.20 μg/dl。所有CH患儿的智力水平均在平均或正常范围内,IQ范围为91 - 108。CH患儿的全量表IQ(107.25 ± 2.9 对比 110.50 ± 2.66,p = 0.001)、言语IQ(106.95 ± 3.5对比109.90 ± 3.44,P值 = 0.001)和操作IQ(106.3 ± 3.68对比108.87 ± 3.70)均低于对照组。然而,在永久性和暂时性CH中,平均IQ分数未观察到统计学上的显著差异。
早期接受治疗且依从性良好的CH患儿具有正常的认知能力,但相对于健康对照组,其IQ可能降低。