Rovet J F, Ehrlich R M, Sorbara D L
Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada.
J Pediatr. 1989 Jan;114(1):63-8. doi: 10.1016/s0022-3476(89)80602-x.
To determine the effect of congenital hypothyroidism and its treatment on infant behavior, we assessed temperament in 50 six-month-old infants with congenital hypothyroidism detected by means of screening of neonates. Intelligence and temperament were also evaluated at 12, 18, 24, and 36 months. More of these children were classified as "difficult" than children in the nonhypothyroid standardization sample. Temperamental difficulty was associated with increased nervous system sensitivity, reflecting more intense responses and a lower threshold of response to external stimulation. Greater temperamental difficulty was found to persist until at least age 2 years of age and to be associated with higher circulating triiodothyronine and thyroxine levels between 1 and 3 months of age. Our results suggest that behavioral features should be considered, as well as circulating hormone levels, in determining the proper dose of thyroid hormone replacement in infants with congenital hypothyroidism.
为了确定先天性甲状腺功能减退症及其治疗对婴儿行为的影响，我们对50名通过新生儿筛查发现的先天性甲状腺功能减退症6个月大婴儿的气质进行了评估。还在12、18、24和36个月时对智力和气质进行了评估。与非甲状腺功能减退症标准化样本中的儿童相比，这些儿童中更多被归类为“难养型”。气质困难与神经系统敏感性增加有关，反映出反应更强烈且对外界刺激的反应阈值更低。发现更大的气质困难至少持续到2岁，并且与1至3个月大时较高的循环三碘甲状腺原氨酸和甲状腺素水平有关。我们的结果表明，在确定先天性甲状腺功能减退症婴儿甲状腺激素替代的合适剂量时，应考虑行为特征以及循环激素水平。
