八、预后
甲减患儿的预后因其发病的原因不同而有差异。通常大部分甲减患儿在补充甲状腺激素后,甲减症状消失,机体代谢恢复正常,预后良好。其中,一过性甲减患儿有可能在临床症状缓解后停药,甲减的症状和体征不再复发。但是,大部分甲减患儿需要终身服用甲状腺激素制剂,以维持甲状腺功能在正常水平。
表33-2 婴儿、儿童和青少年左甲状腺素(L-T4)治疗的推荐剂量[13]

参考文献
[1] Skarpa V, Kappaousta E, Tertipi A, et al.Epidemiological characteristics of children with autoimmune thyroid disease[J].Hormones, 2011, 10(3): 207-214.
[2] Persani L,Bonomi M,Radin R, et al.Diagnostic and therapeutic challenges of acquired thyrotropic deficiency[J].Ann Endocrinol (Paris), 2012, 73(2): 138-140.
[3] Foley TP, Jr., Abbassi V, Copeland K C, Draznin M B.Brief report: hypothyroidism caused by chronic autoimmune thyroiditis in very young infants[J].N Engl J Med,1994,330(7):466-468.
[4] Radetti G.Clinical aspects of Hashimoto’s thyroiditis[J].Endocr Dev, 2014, 26: 158-170.
[5] Brown R S.Disorders of the Thyroid Gland in Infancy,Childhood and Adolescence.In: De Groot LJ,Chrousos G, Dungan K,et al.editors.Endotext [Internet][M].South Dartmouth (MA): MDText.com, Inc.; 2000-2012.21.
[6] Pacaud D, Van Vliet G, Delvin E, et al.A Third World endocrine disease in a 6-year-old North American boy[J].J Clin Endocrinol Metab,1995,80(9):2574-2576.(https://www.daowen.com)
[7] 唐诗, 辛颖.儿童桥本甲状腺炎55 例的临床特征[J].实用儿科临床杂志,2012,27 (8): 581-584.
[8] Persani L.Clinical review: Central hypothyroidism: pathogenic,diagnostic, and therapeutic challenges[J].J Clin Endocrinol Metab, 2012, 97(9): 3068-3078.
[9] Yamada M, Mori M.Mechanisms related to the pathophysiology and management of central hypothyroidism[J].Nat Clin Pract Endocrinol Metab, 2008, 4(12): 683-694.
[10] Rovet J F, Daneman D, Bailey J D.Psychologic and psychoeducational consequences of thyroxine therapy for juvenile acquired hypothyroidism[J].J Pediatr, 1993,122(4): 543-549.
[11] Wasniewska M, Corrias A, Aversa T, et al.Comparative evaluation of therapy with L-thyroxine versus no treatment in children with idiopathic and mild subclinical hypothyroidism[J].Horm Res Paediatr, 2012, 77(6):376-381.
[12] Lazarus J, Brown R S, Daumerie C, et al.2014 European Thyroid Association Guidelines for the Management of Subclinical Hypothyroidism in Pregnancy and in Children[J].Eur Thyroid J, 2014, 3(2):76-94.
[13] Lafranchi S.thyroiditis and acquried hypothyroidism [J].Pediatric Annals, 1992, 21(1): 29-39.
[14] Beck-Peccoz P.Treatment of central hypothyroidism[J].Clin Endocrinol, 2011, 74(6): 671-672.
[15] Koulouri O,Auldin M A,Agarwal R, et al.Diagnosis and treatment of?hypothyroidism?in TSH deficiency compared to primary thyroid disease: pituitary patients are at risk of under-replacement with levothyroxine[J].Clin Endocrinol(Oxf),2011, 74(6): 744-749.