重型β-地中海贫血患儿的甲状腺功能与铁过载的关系分析

doi:10.11852/zgetbjzz2019-0844

摘要/Abstract

摘要： 目的分析重型β-地中海贫血(β-TM)儿童的甲状腺功能与铁过载的关系,改善患儿的甲状腺功能。方法 2018年1—12月在珠海市妇幼保健院治疗的44例β-TM儿童,用化学发光法检测其游离T3(FT3)、游离T4(FT4)、促甲状腺素(TSH)、血清铁蛋白(SF),了解β-TM儿童甲状腺功能减退发生率、分析SF与TSH之间的关系。结果 44例β-TM患儿中甲状腺功能减退(PH)共0例,亚临床型甲状腺功能减退共6例(13.6%),SF与TSH之间呈正相关(r=0.399,P＜0.05),亚临床甲状腺功能减退患儿的SF水平[(5 933.00±2 405.41)μg/L]明显增高(t=-3.174,P＜0.05),不规范祛铁组患儿有较高的SF、TSH水平[(5 322.50±1 956.37)μg/L、(9.95±9.27)mU/ml]和亚临床型甲状腺功能减退发生率(33.3%)(t=6.186、2.678,χ²=8.273,P＜0.05)。结论 β-TM患儿甲状腺功能与SF、不规范祛铁有关,需规范祛铁防止甲状腺功能障碍。

关键词: 重型β-地中海贫血, 儿童, 甲状腺功能减退, 铁过载

Abstract: Objective To study the relationship between thyroid function and iron overload in children with β-thalassemia major(β-TM) and to improve the thyroid function. Methods From January to December 2018,44 children with β-TM were treated in Zhuhai Municipal Maternity and Child Health Care Hospital.Their free T3(FT3), free T4(FT4), thyrotropin(TSH) and serum ferritin(SF) were detected by chemiluminescence.The incidence of hypothyroidism in children was investigated and the relationship between SF and TSH was analyzed. Results Among 44 children with β-TM, there were 0 case of hypothyroidism and 6 cases of subclinical hypothyroidism(13.6%).There was a positive correlation between SF and TSH(r=0.399,P＜0.05).The level of SF [(5 933.00±2 405.41)μg/L]in subclinical hypothyroidism children was significantly increased(t=-3.174,P＜0.05).In irregular iron removal group,there were higher levels of SF,TSH[(5 322.50±1 956.37)μg/L,(9.95±9.27)mU/ml] and incidence of subclinical hypothyroidism(33.3%)(t=6.186,2.678,χ²=8.273,P<0.05). Conclusions Thyroid function in children with β-TM is related to SF and irregular iron removal.It is necessary to regulate iron removal to prevent thyroid dysfunction.

Key words: β-thalassemia major, children, hypothyroidism, iron overload

中图分类号:

R725.5

段丽, 黎瞳, 王峰. 重型β-地中海贫血患儿的甲状腺功能与铁过载的关系分析[J]. 中国儿童保健杂志, 2020, 28(1): 86-88.

DUAN Li, LI Tong, WANG Feng. Relationship between thyroid function and iron overload in children with β-thalassemia major[J]. journal1, 2020, 28(1): 86-88.

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