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首页> 外文期刊>Bangladesh Journal of Medical Science >Neurodevelopmental outcome of congenital hypothyroidism in children between 1-5 years of age
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Neurodevelopmental outcome of congenital hypothyroidism in children between 1-5 years of age

机译：1-5岁儿童先天性甲状腺功能减退症的神经发育结局

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Objective: To evaluate growth and development of children with congenital hypothyroidism (CHT) attending Pediatric Endocrine OPD BIRDEM. Methodology: It is a cross sectional study which was conducted at Pediatric outpatient department BIRDEM in a study period of 1 year (May 2008 to April 2009). A total number of 80 children with CHT were included in the study. A data sheet was used for each subject containing all the information. History and thorough physical examination was carried out including anthropometry, and developmental assessment. Developmental assessment was done according to Denver developmental screening test using standard charts of developmental progress which is appropriate for child's age. TSH and FT4 were done by chemiluminescent method in multichannel auto analyzer. Other investigations included bone x ray. Result: Total 80 children with congenital hypothyroidism between 1 to 5 years of age fulfilling the inclusion criteria were studied. Majority of the study population (71.20%) were diagnosed outside BIRDEM and 28.80% at BIRDEM. In the study population, 73.70% children were diagnosed within 1st three month of age and considered as early treated group, 26.20% diagnosed between three to nine month of age and classified as late treated group. Majority (56.20%) of the study population were female, and 43.70% were male child. All children among study sample were from non goiter endemic zone. Only 3 (5.0%) children among early treated group had maternal history of thyroid disorder and H/O ingestion of anti thyroid drugs and none among late treated group. 11(18.6%) early treated group and 2 (9.5%) late treated group children had affected peer with similar disorder and there was no family history of endocrine disorder among either group of study sample. Among 59 early treated group of children only 5(8.4%) had coarse facies, 2(3.3%) had protruded tongue and bradycardia, 4(6.7%) children had dry rough skin, 1(1.6%) was hypotonic, 2(3.3%) had delayed relaxation of ankle jerk and none had wide open fontanel. Out of 21 late treated group of children, 12(57.1%) had coarse facies, 4(19%) had protruded tongue, 6(28.5%) had bradycardia, 15(71.4%) children had dry rough skin, 16(76.1%) was hypotonic, 12(57.1%) had wide open fontanel and delayed relaxation of ankle jerk. Among 59 early treated group of children 53(89.8%), 51(86.4%), 55(93%) had normal and 6(10.1%), 8(13.5%), 4(6.7%) had delayed gross motor, fine motor and cognition respectively. Whereas among 21 late treated group 9(42%), 6(28.5%), 7(33.3%) had normal and 12(57%), 15(71.4%), 14(66.6%) children had delay in gross motor, fine motor and cognition respectively. There was no visual impairment among either group of children in study sample. Among 59 early treated group of children 57(96.6%) had normal hearing and 47(82.6%) had normal speech. Whereas among 21 late treated group, hearing impairment was seen among 7(25.9%) and speech delay was noticed among 16(76.1%) children. Among early treated group only 2% children had delayed radiological bone age, whereas 6% children among late treated group had delayed bone age. Conclusion: Congenital Hypothyroidism (CHT) is a serious condition of newborn babies, which leads to permanent mental and physical retardation if not identified within first few weeks of life. It is concluded that, the later the treatment is started the poorer the outcome will be. DOI: http://dx.doi.org/10.3329/bjms.v10i4.9495 BJMS 2011; 10 (4): 245-251
机译：目的：评估小儿内分泌OPD BIRDEM患先天性甲状腺功能减退症（CHT）的儿童的生长发育。方法：这是一项横断面研究，在1年（2008年5月至2009年4月）的研究期间在儿科门诊BIRDEM进行。该研究总共包括80名CHT儿童。每个主题都使用了一个数据表，其中包含所有信息。进行了历史和彻底的身体检查，包括人体测量学和发育评估。根据丹佛发育筛查测试，使用适合儿童年龄的标准发育进度图进行发育评估。 TSH和FT4是在多通道自动分析仪中通过化学发光法完成的。其他检查包括骨X射线检查。结果：共研究了80例符合纳入标准的1至5岁的先天性甲状腺功能减退儿童。大部分研究人群（71.20％）被诊断为在BIRDEM之外，而在BIRDEM诊断为28.80％。在研究人群中，有73.70％的儿童被诊断为在第一三个月之内被视为早期治疗组，有26.20％的儿童在三至九个月的被诊断为晚期治疗组。研究人群中的大多数（56.20％）为女性，而男孩为43.70％。研究样本中的所有儿童均来自非甲状腺肿地方病区。早期治疗组中只有3名儿童（5.0％）有甲状腺疾病的母体病史和H / O摄入抗甲状腺药物，而晚期治疗组则没有。早期治疗组中有11（18.6％）儿童和晚期治疗组中有2（9.5％）儿童患有类似疾病，并且在两组研究样本中均没有内分泌疾病的家族史。在59个早期治疗的儿童组中，只有5个（8.4％）的人有粗糙的相，2（3.3％）的人的舌头和心动过缓，4（6.7％）的人的皮肤干燥粗糙，1（1.6％）的低渗的，2（3.3 ％）的脚踝抽搐延迟了放松，而且没有人打开font门。在21个晚期治疗组的儿童中，有12个（57.1％）的脸部粗糙，4个（19％）的舌头伸出，6个（28.5％）的心动过缓，15个（71.4％）的孩子皮肤干燥粗糙，16个（76.1％） ）为低渗性，12（57.1％）的open门开放且踝关节抽动延迟延迟。在59例早期治疗的儿童中，有53例（89.8％），51例（86.4％），55例（93％）正常，6例（10.1％），8例（13.5％），4例（6.7％）患有大运动迟缓，罚款运动和认知。在21例晚期治疗组中，9例（42％），6例（28.5％），7例（33.3％）正常，而12例（57％），15例（71.4％），14例（66.6％）的儿童运动迟缓，精细运动和认知。在研究样本的任何一组儿童中都没有视觉障碍。在59例早期治疗的儿童中，有57名（96.6％）的听力正常，有47名（82.6％）的语音正常。在21个晚期治疗组中，有7名（25.9％）出现听力障碍，有16名（76.1％）的儿童出现语言障碍。在早期治疗组中，只有2％的儿童有放射线的骨龄延迟，而在晚期治疗组中有6％的儿童具有放射线的骨龄。结论：先天性甲状腺功能减退症（CHT）是新生儿的一种严重疾病，如果在生命的最初几周内未发现，则会导致永久性的智力和身体发育迟缓。结论是，开始治疗越晚结果越差。 DOI：http：//dx.doi.org/10.3329/bjms.v10i4.9495 BJMS 2011; 10（4）：245-251

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