根据初始促甲状腺激素水平预测暂时性或永久性先天性甲状腺功能减退症
Prediction of Transient or Permanent Congenital Hypothyroidism from Initial Thyroid Stimulating Hormone Levels.
作者信息
Scavone Maria, Carboni Elena, Stefanelli Ettore, Romano Giusy, Vero Anna, Giancotti Laura, Miniero Roberto, Talarico Valentina
机构信息
Unit of Pediatrics, Magna Graecia University of Catanzaro, Catanzaro, Italy.
Unit of Laboratory Medicine, Pugliese-Ciaccio Hospital; Catanzaro, Italy.
出版信息
Indian Pediatr. 2018 Dec 15;55(12):1059-1061.
OBJECTIVE
To identify factors that discriminate between transient and permanent congenital hypothyroidism.
METHODS
Retrospective evaluation of 58 children with congenital hypothyroidism and eutopic thyroid gland. Gender, gestational age, birth weight, TSH and serum thyroxine levels at diagnosis and L-thyroxine dose at 12 and 24 months of age were analyzed.
RESULTS
Median (IQR) initial TSH levels were 73.3 (276.5) µIU/mL in permanent hypothyroidism and 24.24 (52.7) µU/mL in transient hypothyroidism (P =0.0132). The optimum cut-off value of initial TSH to predict transient hypothyroidism was 90 µIU/mL. Mean (SD) L-thyroxine doses at 24 months of age were 2.64 (0.98) µg/kg/day in permanent hypothyroidism and 1.91 (0.65) µg/kg/day in transient hypothyroidism. Requirement of L-thyroxine dose at 24 months of ≤0.94 µg/kg/day had the highest sensitivity (100%) to predict transient hypothyroidism.
CONCLUSIONS
L-thyroxine doses at 24 months can predict transient hypothyroidism in patients with eutopic thyroid gland earlier than at 36 months.
目的
确定区分暂时性和永久性先天性甲状腺功能减退症的因素。
方法
对58例甲状腺位置正常的先天性甲状腺功能减退症患儿进行回顾性评估。分析患儿的性别、胎龄、出生体重、诊断时的促甲状腺激素（TSH）和血清甲状腺素水平，以及12个月和24个月时的左旋甲状腺素剂量。
结果
永久性甲状腺功能减退症患儿初始TSH水平的中位数（四分位间距）为73.3（276.5）μIU/mL，暂时性甲状腺功能减退症患儿为24.24（52.7）μU/mL（P =0.0132）。预测暂时性甲状腺功能减退症的初始TSH最佳临界值为90μIU/mL。永久性甲状腺功能减退症患儿24个月时左旋甲状腺素的平均（标准差）剂量为2.64（0.98）μg/kg/天，暂时性甲状腺功能减退症患儿为1.91（0.65）μg/kg/天。24个月时左旋甲状腺素剂量≤0.94μg/kg/天对预测暂时性甲状腺功能减退症的敏感性最高（100%）。
结论
对于甲状腺位置正常的患者，24个月时的左旋甲状腺素剂量比36个月时能更早地预测暂时性甲状腺功能减退症。
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