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目的:了解重型地中海贫血铁过载对生长发育和甲状腺功能的影响及其干预措施。方法:观察组选择2～19岁重型地贫73例,血清铁蛋白(SF)均≥1 000μg/L,对照组为同期2～19岁儿童保健中心体检的儿童78例,排除贫血,SF在正常范围。所有病例测量身高、体重并进行评价,评价标准根据2007年WHO制订的《0～19岁儿童身高体重标准》;所有病例用化学发光免疫法检测甲状腺功能(FT3、FT4、TSH)。结果:观察组身高在均值以下的占83.6%,对照组身高在均值以下的占15.4%(12/78),两组身高值经统计学比较差异有统计学意义,重型地贫组身材矮小。观察组有17例(23.3%)符合亚临床甲低诊断,对照组甲状腺功能均正常。17例亚临床甲低口服左甲状腺素钠片治疗,16例治疗1～3个月甲功值正常,有效率94.1%。结论:重型地贫铁过载合并生长发育障碍显著,合并亚临床甲低者较多,长期定期监测甲功很有必要,早期采取干预措施能提高患者生活质量。
Objective: To understand the effect of iron overload in thalassemia major on growth and thyroid function and its intervention measures. Methods: In the observation group, 73 cases of severe thalassemia major were aged 2-19 years old. The serum ferritin (SF) was ≥1 000 μg / L in the observation group. 78 children in the health center of children aged 2-19 years in the control group were excluded. normal range. All cases were measured height and weight, and evaluation criteria based on the 2007 WHO developed “height and weight of children aged 0-19 years of standard”; all cases of thyroid function by chemiluminescence immunoassay (FT3, FT4, TSH). Results: The height of the observation group accounted for 83.6% below the mean value, while the height of the control group below the average value accounted for 15.4% (12/78). There was statistically significant difference in height between the two groups. 17 cases (23.3%) in the observation group met the diagnosis of subclinical hypothyroidism, while the control group had normal thyroid function. 17 cases of subclinical hypothyroidism oral levothyroxine tablets treatment, 16 cases of 1 to 3 months of normal thyroid function, the effective rate of 94.1%. Conclusion: There is a significant obstacle to the overloading of heavy thalassemia combined with growth and development. It is necessary to monitor thyroid function by long-term regular monitoring. Early intervention can improve the quality of life of patients.