摘要
目的研究早产儿中暂时性低甲状腺素血症和低三碘甲状腺原氨酸（T3）综合征的影响因素。方法选取出生胎龄为26～36周的早产儿418例，在生后2周左右检测甲状腺素（T4）、T3、促甲状腺激素（TSH），根据甲状腺功能将对象分为暂时性低甲状腺素血症（TH）组、低B综合征组、正常对照组3组。收集20种可能相关的围产期因素，并用卡方检验和logistic回归对影响因素进行分析。结果分组后TH组49例、低．T3综合征组35例、正常对照组334例，TH的患病率为11．7％，低T3综合征的患病率为8．4％。20种因素中，对TH有影响的围产期因素为：男性（OR=1．863，95％C10．966～3．594），生后应用白蛋白（OR=2．401，95％CI1．294～4．455），生后应用多巴胺（OR=3．295，95％CI1．110—9．783）；对低r乃综合征有影响的围产期因素为：男性（OR：2．592，95％CI1．171～5．736），出生胎龄≤28周（OR=3．503，95％CI1．275—9．627）。结论男性、生后应用白蛋白和多巴胺是TH的危险因素；男性和出生胎龄≤28周是低T3综合征的危险因素。应用这些危险因素可以筛选出TH和低B综合征的高危新生儿，便于制定合理的治疗方案。
Objective To investigate the influencing factors of transient hypothyroxinemia （THT） and low T3 syndrome （LT3S） in premature infants. Method We have studied 418 premature infants whose gestatioual age was between 26 and 36 weeks. Serum thyronine （T4）, triiodothyronine （T3） and thyrotropin （TSH） of them were detected on the fourteenth day approximately after birth. The patients were divided according to their serum T4, T3 and TSH into 3 groups （transient hypothyroxinemia, low 3＂3 syndrome and normal）. Then 20 Perinatal factors which may be associated with THT and LT3S were collected. The factors were analyzed by using Chi-square test and Logistic regression. Result Forty-nine infants were found suffering from THT, 35 infants suffering from LT3S, and 334 infants in normal group. The prevalence rate of THT was 11.7% , and the prevalence rate of LT3S was 8. 4%. Among the 20 factors, the factors related to the incidence of THT were male gender （ OR = 1. 863, 95% CI O. 966 - 3. 594） , albumin （ OR = 2. 401, 95%CI 1.294 -4.455）, dopamine （OR =3.295, 95%CI 1.110 -9.783） and those related to the incidence of LT3S were male gender （ OR = 2. 592, 95% CI 1. 171 - 5.736） , gestational age ~〈 28 wk （ OR = 3. 503, 95% CI 1. 275 - 9. 627 ）. Conclusion Male gender, albumin and dopamine are perinatal risk factors of THT, meanwhile, male gender and gestational age 〈 28 wk are perinatal risk factors of LT3S. With the use of risk factors identified in our study, it may be possible to separate infants having the highest risk of THT and LT3S, so as to form optimizing treatment strategies.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2013年第8期607-611,共5页
Chinese Journal of Pediatrics
