| 摘要: |
| 目的：总结6例新生儿甲状腺功能亢进症临床特点及诊治经验。方法：收集2013年6月至2020年1月我院收治的6例新生儿甲亢病例资料，并结合文献分析。结果：6例患儿的母亲均有甲状腺病史，且孕期未监测促甲状腺激素受体抗体（TRAb），日龄7~15 d出现典型甲亢症状，以心率增快和呼吸急促最常见，另有1例以呼吸道分泌物增多为突出表现且合并甲亢危象。6例患儿经甲巯咪唑1.0~1.5 mg/（kg·d）治疗后好转，住院6~38 d带药出院。其中5例为暂时性甲亢，随访至2月龄时停药；1例为持续性甲亢，8月龄时仍有甲状腺功能异常，伴发育落后、髋关节发育不良、骨龄超前，2岁4个月时甲状腺功能恢复正常停药。结论：应加强有甲状腺病史的高危孕产妇管理，动态监测母亲和新生儿的TRAb，以便预测及早期诊断新生儿甲亢。新生儿甲亢经及时合理的药物治疗，多数预后良好 |
| 关键词: 新生儿 甲状腺功能亢进症 临床分析 促甲状腺激素受体抗体 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2021.07.004 |
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| 基金项目: |
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| Clinical Analysis and Experience of Diagnosis and Treatment of 6 Cases of Neonatal Hyperthyroidism |
| Peng Sicong, Tian Juan, Xia Shiwen, Zhang Yi |
| (Maternal and Child Health Hospital of Hubei Province, Hubei Wuhan 430070, China) |
| Abstract: |
| Objective: To summarize the clinical features, diagnosis and treatment of 6 cases of neonatal hyperthyroidism. Methods: Medical records of 6 cases of neonatal hyperthyroidism from Jun. 2013 to Jan. 2020 were collected and analyzed in combination with literature. Results: Six neonates had maternal thyroid disease without monitoring thyrotrophin receptor antibody (TRAb) during pregnancy, and presented typical symptoms of hyperthyroidism for 7 to 15 d after birth. Increased heart rate and shortness of breath were the most common symptoms, and one case was characterized by increased respiratory secretions and hyperthyroidism crisis. Six cases who recovered after treatment with methimazole from 1.0 to 1.5 mg/(kg·d) were stayed in hospital for 6 to 38 d and discharged with medication. Five cases were diagnosed with temporary hyperthyroidism, and the drug was discontinued at 2 months of age. One case had persistent hyperthyroidism and still had abnormal thyroid function at 8 months of age, with developmental retardment, dysplasia of hip join and advanced bone age; the thyroid function returned to normal state at 2 years and 4 months of age and the drug was discontinued. Conclusion: Management of high-risk pregnant women with thyroid disease should be strengthened, TRAb of the mothers and neonates are supposed to be dynamically monitored to early predict and diagnose the neonatal hyperthyroidism. The prognosis of most neonates with hyperthyroidism is good after timely and reasonable medical treatment. |
| Key words: neonates hyperthyroidism clinical analysis thyrotrophin receptor antibody |
