过渡性与永久性先天性甲状腺功能低下症:甲状腺体体积是否说明了故事?
Sarah A Ackah1, Erica A Eugster1, Todd D Nebesio1
1Riley Hospital for Children, Department of Pediatrics, Pediatric Endocrinology Section, Indiana University School of Medicine, Indianapolis, Indiana.
概括
甲状腺超声波可以帮助区分永久性和短暂的先天性甲状腺功能低下症 (CH). 较小的甲状腺体体积与短暂的CH有关,而较大的体积表明永久的CH,有助于治疗决策.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 诊断成像 诊断成像 诊断成像
- 新生儿查 新生儿查
背景情况:
- 遗传性甲状腺功能低下症 (CH) 呈现为暂时或永久的形式.
- 区分这些形式对于适当的管理和预后至关重要.
- 甲状腺体积的评估是一种潜在的诊断工具.
研究的目的:
- 评估超声波测量甲状腺体积的有用性,以区分短暂的和永久的先天性甲状腺功能低下症.
- 评估甲状腺体量和甲状腺刺激激素 (TSH) 水平的预测值.
主要方法:
- 对CH和eutopic甲状腺症患者 (2005-2019) 的回顾性分析.
- 永久性CH定义为持续的Levothyroxine需要年龄后3;通过成功戒断的暂时性CH.
- 统计比较包括费舍尔的精确测试,t测试,ROC曲线分析和分类树.
主要成果:
- 暂时性 (1.0 ± 0.5毫升) 和永久性CH (2.3 ± 2.6毫升) 之间的TSH水平和甲状腺体体积的显著差异.
- 在过渡性CH.中,甲状腺体体积从0.3毫升到2.5毫升不等.
- 结合TSH (≥200 mIU/L) 和甲状腺体积 (≤0.6 mL或≥2.5 mL),达到78.4%的灵敏度和85.7%的特异性.
结论:
- 甲状腺体积≥2.5毫升或≤0.36毫升仅在永久性CH中观察到.
- 结合TSH水平和甲状腺体积,可以提高CH形式的诊断准确度.
- 这种方法可能有助于避免不必要的Levothyroxine戒断试验.
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