先天性甲状腺功能减退症治疗后的血清甲状腺素和促甲状腺激素浓度
Serum thyroxine and thyroid stimulating hormone concentrations after treatment of congenital hypothyroidism.
作者信息
Abusrewil S S, Tyfield L, Savage D C
机构信息
Bristol Royal Hospital for Sick Children.
出版信息
Arch Dis Child. 1988 Nov;63(11):1368-71. doi: 10.1136/adc.63.11.1368.
Abstract
Serum thyroid stimulating hormone and thyroxine concentrations were monitored in 42 infants who had been treated for congenital hypothyroidism. Serum thyroid stimulating hormone concentrations were raised in 22 of the infants (52%) at 2 to 4 months, in 16 (38%) at 5 to 11 months, in 14 (33%) at 12 to 18 months, and in eight (19%) at 2 to 4 years. Serum thyroxine and the dose of L-thyroxine/kg/body weight were significantly lower in those infants with raised thyroid stimulating hormone concentrations. Thyroid stimulating hormone was appropriately suppressed when the dose of L-thyroxine was increased, and only one child had delayed maturation of the hypothalamic/pituitary/thyroid axis. We believe it is the infant's rapid gain in weight in the first two years of life that necessitates this decrease in the dose of L-thyroxine/kg body weight and recommend that the treatment of this age group is reviewed every two to three months.
摘要
对42例接受先天性甲状腺功能减退症治疗的婴儿进行了血清促甲状腺激素和甲状腺素浓度监测。2至4个月时，22例婴儿（52%）血清促甲状腺激素浓度升高；5至11个月时，16例（38%）升高；12至18个月时，14例（33%）升高；2至4岁时，8例（19%）升高。促甲状腺激素浓度升高的婴儿，其血清甲状腺素和L-甲状腺素剂量/千克体重显著降低。增加L-甲状腺素剂量时，促甲状腺激素得到适当抑制，只有1名儿童下丘脑/垂体/甲状腺轴成熟延迟。我们认为，正是婴儿在生命的头两年体重快速增加，才需要降低L-甲状腺素剂量/千克体重，并建议每两到三个月对该年龄组的治疗进行复查。
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本文引用的文献
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2
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3
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4
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