Baysal Bahar Toklu, Baysal Bora, Genel Ferah, Erdur Baris, Ozbek Erhan, Demir Korcan, Ozkan Behzat
Departments of Pediatrics and Pediatric Endocrinology, Dr. Behcet Uz Children's Hospital; and Departments of Neonatology and Pediatric Endocrinology, Dokuz Eylul University, School of Medicine Izmir, Turkey. Correspondence to: Dr Bahar Toklu Baysal, Department of Pediatrics, Dr. Behcet Uz Children's Hospital, Izmir, Turkey.
Indian Pediatr. 2017 May 15;54(5):381-384. doi: 10.1007/s13312-017-1111-5. Epub 2017 Mar 29.
To study the factors affecting a neurodevelopmental status of children with congenital hypothyroidism, diagnosed on national screening program.
The study was performed in the Pediatric Endocrinology Department of Dr. Behcet Uz Children's Hospital between May 2012 and May 2013. Children with congenital hypothyroidism, aged between 24 and 36 months, diagnosed by national screening program were included in the study group. Healthy subjects at the same age group consisted of the control group. For the neurodevelopmental evaluation, Bayley Scale of Infant Development- II (BSID-II) was used. Factors possibly effective on neurodevelopment were evaluated.
42 patients and 40 healthy children (mean (SD) age, 29.4 (3.7) and 29.2 (3.5), respectively were included in the study. The mean MDI score [92.6 (7.07) vs 97.1 (9.69), P=0.14)] and the mean PDI score [97.8 (15.68) vs 99.1 (10.57), P=0.66)] in the study group and control group were not significantly different. Among the patient, 4.6% and 4.7% children were moderately retarded as per the MDI scores and PPI scores, respectively. The sex, socioeconomic status, birth weight, screening levels of TSH, severity of the congenital hypothyroidism, initiation time and the dosage of thyroid hormone replacement, length of the normalization period of TSH, and adherence to treatment were not found to affect the MDI and PDI scores of the patients.
Some children with congenital hypothyrodism may have mild to moderate neurodevelopmental retardation, despite the early diagnosis and treatment, and thus need to be under regular follow-up for neurodevelopmental status.
研究在国家筛查项目中确诊的先天性甲状腺功能减退症患儿神经发育状况的影响因素。
本研究于2012年5月至2013年5月在贝赫切特·乌兹儿童医院儿科内分泌科进行。通过国家筛查项目确诊的年龄在24至36个月的先天性甲状腺功能减退症患儿被纳入研究组。同年龄组的健康受试者组成对照组。采用贝利婴儿发展量表第二版（BSID-II）进行神经发育评估。评估可能对神经发育有影响的因素。
42例患者和40名健康儿童（平均（标准差）年龄分别为29.4（3.7）岁和29.2（3.5）岁）被纳入研究。研究组和对照组的平均智力发育指数（MDI）得分[92.6（7.07）对97.1（9.69），P = 0.14]和平均运动发育指数（PDI）得分[97.8（15.68）对99.1（10.57），P = 0.66]无显著差异。在患者中，根据MDI得分和PDI得分，分别有4.6%和4.7%的儿童为中度发育迟缓。未发现性别、社会经济状况、出生体重、促甲状腺激素（TSH）筛查水平、先天性甲状腺功能减退症的严重程度、甲状腺激素替代治疗的起始时间和剂量、TSH正常化期的时长以及治疗依从性对患者的MDI和PDI得分有影响。
一些先天性甲状腺功能减退症患儿尽管早期诊断并接受了治疗，但仍可能有轻度至中度神经发育迟缓，因此需要定期随访其神经发育状况。
