摘要
目的对先天性甲状腺功能减退症患儿应用左旋甲状腺素钠替代治疗的初始药物剂量进行探讨。方法对2018年5月~2019年5月就诊的90例先天性甲状腺功能减退症患儿进行分组(随机法)研究,甲组、乙组和丙组,每组各30例。所有患儿均经左旋甲状腺素钠进行替代治疗,甲组初始剂量是每天6μg/kg,乙组初始剂量是每天8μg/kg,丙组初始剂量是每天10μg/kg,比较三组的智力发育情况、甲状腺功能指标、甲状腺功能指标正常率、不良反应。结果三组患儿的智力正常率比较、发育评分比较差异无统计学意义(P>0.05)。甲组甲状腺素水平小于乙组和丙组,乙组甲状腺素水平小于丙组,差异有统计学意义(P<0.05)。甲组血清游离甲状腺素水平小于乙组和丙组,乙组甲状腺素水平小于丙组,差异有统计学意义(P<0.05)。甲组促甲状腺激素水平大于乙组和丙组,乙组甲状腺素水平大于丙组,差异有统计学意义(P<0.05)。三组患儿的甲状腺素正常率、血清游离甲状腺素正常率、促甲状腺激素正常率比较差异均无统计学意义(P>0.05)。三组患儿的不良反应总发生率比较差异无统计学意义(P>0.05)。结论先天性甲状腺功能减退症患儿,应用左旋甲状腺素钠进行替代治疗的效果确切,不同初始药物剂量对患儿智力发育产生的影响没有差异,但低剂量(每天6μg/kg)稍显不足,而高剂量(每天10μg/kg)剂量稍大,因此推荐中剂量(每天8μg/kg)对患儿进行治疗。
Objective To explore the initial dose of levothyroxine sodium replacement therapy in children with congenital hypothyroidism.Methods A total of 90 children with congenital hypothyroidism who came to our hospital from May 2018 to May 2019 were divided into groups(randomized),group A,group B and group C,30 cases in each group.All children received replacement therapy with levothyroxine sodium.The initial dose of group A was 6μg/kg per day,the initial dose of group B was 8μg/kg per day,and the initial dose of group C was 10μg/kg per day.Compare the mental development,thyroid function index,normal rate of thyroid function index,adverse reactions of the three groups.Results There was no significant difference in the normal rate of intelligence and development scores among the three groups A,B and C(P>0.05).The level of thyroxine in group A was lower than that in groups B and C,and the level of thyroxine in group B was lower than that in group C,the difference was significant(P<0.05).The level of serum free thyroxine in group A was lower than that in groups B and C,and the level of thyroxine in group B was lower than that in group C,the difference was significant(P<0.05).The level of thyroid stimulating hormone in group A was greater than that in groups B and C,and the level of thyroxine in group B was greater than that in group C,the difference was significant(P<0.05).The normal rate of thyroxine,normal rate of serum free thyroxine,and normal thyroid stimulating hormone were not significant among the three groups A,B,and C(P>0.05).There was no significant difference in the total incidence of adverse reactions between the three groups A,B and C(P>0.05).Conclusion In children with congenital hypothyroidism,the effect of replacement therapy with levothyroxine sodium is accurate.There is no difference in the effect of different initial drug doses on the mental development of children,but the low dose(6μg/kg per day)is slightly significantly insufficient,and the high dose(10μg/kg per day)dose is slightly larger,so it
作者
高志华
GAO Zhi-hua(Department of Pediatrics,Xiangya Changde Hospital,Changde 415000,China)
出处
《中国处方药》
2021年第2期102-104,共3页
Journal of China Prescription Drug
