Objective To observe and analyze the change of growth velocity (GV), height age (HA) and bone age (BA) of children with hypothyroidism before and after treatment with ievothyroxinc sodium, which reveal the regularity of linear growth. Methods Twenty-six children's X-ray films of left hands and wrists were observed as well as GVandHA, at the same time. Serum levels of T3, T4, FB, FT4, thyrotrophic stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb) and thyroglobulm antibody (TGAb} were detected by means of chernilurninescence imnmnoassay. Results The HA and BA of children with hypothyroidism were younger than their chronological age (CA) before treatment. They achieved catch up growth that the ABA and AHA were faster than AC A after treatment. During the treatment, the ABA and AHA presented decrement tendency and kept parallel. In addition, the growth retardations or arrests were improved. Conclusions Levothyroxine sodium has the effect of promoting linear growth for children with hypothyroidism. HA and BA inspection have important instructional significance in diagnosis, therapeutic effect and prognosis judgement of hypothyroidism in children.%目的 观察分析左甲状腺素钠治疗甲状腺功能减低症(甲低)患儿的生长速率(GV)、身高年龄(HA)及骨龄(BA)变化情况,探寻HA、BA与生活年龄(CA)间的变化,揭示其线性生长规律.方法对确诊为甲状腺功能减低症的26例患儿进行随访,于治疗前及治疗过程中监测身高,计算GV、HA并拍摄X线骨龄片;同时用化学发光法检测血清三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3)、甲状腺素(T4)、游离甲状腺素(FT4)、促甲状腺素(TSH)、抗甲状腺过氧化酶抗体(TPOAb)及抗甲状腺球蛋白抗体(TGAb).结果 甲状腺功能减低症患儿治疗前,BA和HA明显小于CA,经左甲状腺素钠治疗后,BA和HA呈现追赶生长现象,即骨龄增加(ΔBA)和身高年龄增加(ΔHA)大于生活年龄增加(ΔCA).治疗过程中ΔBA与ΔHA呈递减趋势,且两者保持平行,即ΔBA/ΔHA接近1.结论 左甲状腺素钠对甲状腺功能减低症患儿具有明显的促线性生长作用,动态观察BA及HA对甲状腺功能减低症患儿的诊断、治疗及预后判断有重要的临床指导意义.
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