摘要
目的研究早产儿甲状腺功能，探讨早产儿暂时性甲状腺功能减低症是否应进行早期临床干预。方法将180例早产儿按胎龄（GA）分成小胎龄组和大胎龄组，正常足月儿组90例，测定3组生后第7天的血清游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）。将诊断为暂时性甲状腺功能减退的早产儿随机分为治疗组和非治疗组，治疗组给予左旋甲状腺素8μg/（kg·d）治疗，生后第21天复查FT3、FT4、TSH，对比两组FT3、FT4、TSH的值，并评价黄疸、喂养、体重增长、神经系统发育指标等。结果FT3、FT4和TSH值小胎龄组分别为（2．8±0．2）pmol／L、（14．2±0．4）pmol／L和（4．5±0．4）mU／L，大胎龄组分别为（3．8±0．4）pmol／L、（18．5±0．4）pmol／L和（4．1±0．4）mU／L，差异均有统计学意义。治疗组生后第21天的FT3、FT4值比生后7d均有回升，分别为（3．4±0．3）pmol／L、（7．7±0．3）pmol／L。治疗组体重增加较快，达全胃肠喂养、黄疸消退时间及住院时间均缩短；神经系统发育指标较好。结论早产儿存在暂时性甲状腺功能减低症，胎龄越小，功能越低。早期干预治疗有利于原发病的康复及预防脑损害。
Objective To evaluate thyroid function and to investigate the effect of clinical intervention on transient hypothyroidism in premature infants. Methods A total of 180 cases of premature infants were divided into two groups： very small gestational age （VSGA） group and small gestational age （SGA） group; ninety full-term infants were used as controls. Free triiodothyronine （FT）, free thyroxine （FT4 ）, and thyroid-stimulating hormone （TSH） of the three groups were assessed on the seventh day. Of the premature infants, 32 with low FT3 or low FT4 were randomly divided into two groups, the treatment group （16 cases） and the non-treatment group （16 cases）. The treatment group was given L-thyroxine, 8 Ixg（ kg · d）. After two weeks, FT3, FT4, and TSH were determined again and were compared between the two groups. Jaundice, feed intolerance, weight gain, and neural system development were also compared between the two groups. Results Concentrations of FT3, FF4, and TSH were （2.8±0.2） pmol/L, （14.2 ±0.4） pmol/L, and （4.5 ± 0.4） mU/L, respectively, in the VSGA group, compared with （3.8 ± 0.4） pmol/L, （ 18.5 ± 0.4） pmol/L, and （4.1 ± 0.4） mU/L, respectively, in the SGA group, with all differences being significant in these indicators between the two groups. Concentrations of FT3 and FF4 in the treatment reached to （3.4 0.3 ） pmol/L and （7.7 ± 0.3 ） pmol/L, respectively, after treatment for 21 days. All of these values were higher than those at the 7th day after birth. Compared with the non-treatment group, the treatment group gained weight more quickly, had short time to reach full enteral feeding, jaundice disappearance, and discharged, and gained higher score of neural system development. Conclusion Transient hypothy-roidism occurs in premature infants. The smaller in gestational age, the poor of thyroid function. Early intervention is beneficial for the recovery of diseases and the prevention of brain damage.
出处
《中国生育健康杂志》
2013年第1期18-21,共4页
Chinese Journal of Reproductive Health
关键词
早产儿
甲状腺功能
干预治疗
Premature Infants
Thyroid Function
Intervention therapy
