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目的探讨先天性甲状腺功能减低症(CH)患儿血清TSH、FT4、FT3含量变化,为临床诊治提供依据。方法对502例CH进行病因学分类和甲状腺核素扫描,并用化学发光法测定血清TSH、FT4、FT3含量。结果 502例CH随访2年后,有126例确诊为暂时性CH,376例确诊为永久CH。126例暂时性CH甲状腺核素扫描基本正常;在376例永久性CH患儿中,113例甲状腺基本正常,58例甲状腺缺如,55例甲状腺异位,38例摄锝功能低下,112例甲状腺发育不良;暂时性CH和永久性CH患者血清TSH、FT4有显著性差异(P<0.01),FT3差异不显著(P>0.05),甲状腺缺如、异位、发育不良、摄锝功能低下患者与甲状腺正常的永久性CH患儿TSH、FT4有显著性差异(P<0.05),FT3差异不显著(P>0.05)。结论甲状腺核素扫描与血清TSH、FT4、FT3测定可为CH的病因学分类及疾病诊断、治疗和预后判断提供依据。
Objective To investigate the changes of serum TSH, FT4 and FT3 in children with congenital hypothyroidism (CH) and provide evidence for clinical diagnosis and treatment. Methods 502 cases of CH were etiologically classified and thyroid radionuclide scanning, and chemiluminescence method for the determination of serum TSH, FT4, FT3 content. Results 502 patients were followed up for 2 years, 126 cases were diagnosed as transient CH, 376 cases were diagnosed as permanent CH. 126 cases of temporary CH thyroid radionuclide scan was normal; in 376 cases of permanent CH children, 113 cases of thyroid basically normal, 58 cases of thyroid absence, 55 cases of thyroid heterotopic, 38 cases of poorly administered technetium, 112 cases of thyroid Dysplasia; serum TSH, FT4 in patients with temporary CH and permanent CH had significant difference (P <0.01), but there was no significant difference in FT3 (P> 0.05), thyroid absence, ectopic, dysplasia, There was a significant difference (P <0.05) between TSH and FT4 in permanent CH children with normal thyroid gland and no significant difference in FT3 (P> 0.05). Conclusions The thyroid radionuclide scan and serum TSH, FT4 and FT3 determination may provide the basis for the etiological classification of CH and the diagnosis, treatment and prognosis of CH.