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在经过重新评估后的甲状腺功能测试中,暂时和永久的先天性甲状腺功能低下症之间的比较.
Song Han Lee1, Hyun Gyung Lee1, Eun Mi Yang1
1Department of Pediatrics, Chonnam National University Medical School & Children's Hospital, Gwangju, Korea.
Annals of pediatric endocrinology & metabolism
|January 4, 2024
概括
过渡性先天性甲状腺功能低下症 (TCH) 需要在停止服用勒沃西后重新评估. 甲状腺功能测试,特别是甲状腺刺激激素 (TSH),有助于预测儿童的永久性先天性甲状腺功能低下症 (PCH).
科学领域:
- 儿科内分泌学 儿科内分泌学
- 新生儿查 新生儿查
- 甲状腺功能测试 甲状腺功能测试
背景情况:
- 先天性甲状腺功能低下症 (CH) 是通过新生儿查诊断和新生儿治疗.
- 过渡性CH (TCH) 是一种需要重新评估以停止治疗的CH子集.
- 确定在TCH中停止使用levothyroxine的最佳策略至关重要.
研究的目的:
- 确定在CH患者中停止使用levothyroxine的最佳方法.
- 分析在停止服用莱沃西后甲状腺功能测试 (TFT) 的趋势.
- 要区分暂时性和永久性CH (PCH).
主要方法:
- 对388名被诊断患有心血管疾病的患者进行了回顾性审查.
- 将患者分为永久性CH (PCH) 和TCH组 (共83名患者).
- 临床参数和TFT趋势的比较,以预测TCH.
主要成果:
- 在PCH组中断后和1-3年内观察到较高的甲状腺刺激激素 (TSH) 水平 (P<0.01).
- 在TCH组中断后和1-3年内观察到较高的自由甲状腺素 (fT4) 水平 (P<0.01).
- 3年平均TSH>9.05μIU/mL准确预测PCH,具有100%的灵敏度和特异性.
结论:
- 当TSH在1020μIU/mL之间时,可以停止使用levothyroxine,随后的结果约为10μIU/mL或下降.
- 甲状腺功能测试趋势,特别是TSH,是管理TCH再评估的关键指标.
- 三年平均TSH切线>9.05μIU/mL可靠地识别PCH.
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