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目的研究早产儿甲状腺功能。方法将青岛大学医学院附属医院2004年10月至2005年10月收治的早产儿60例按胎龄分成两组小胎龄早产儿组(A组,胎龄<34周,n1=30),大胎龄早产儿组(B组,胎龄≥34周,n2=30)。对照组为我院出生的正常足月儿30例,应用放免法对3组新生儿生后第1,7天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)水平进行测定。结果A、B组及对照组血清FT3、FT4生后1～7d呈下降趋势;对照组生后第1,7天血清FT3、FT4明显高于A、B组,B组明显高于A组;血清TSH在A、B及对照组生后呈下降过程;生后第1天对照组TSH>A组>B组;生后第7天,血清TSHA组高于B组和对照组,而B组与对照组差异无显著性。结论早产儿生后甲状腺功能有暂时性低下,胎龄越小,功能越低,生后应激反应持续时间越长。

Observation on thyroid function in premature infants

Objective To investigate the thyroid function in the premature infants.Methods From Oct.2004 to Oct.2005 serum free triodothyrorine (FT_3),free thyroxine (FT_4) and thyrotropin (TSH) in 60 premature infants on the 1st,7th days after birth were detected by radioimmunoassay (RIA) and were compared with those in 30 normal neonate controls.The 60 premature infants were divided into two groups according to the gestational age:the very premature infants (the group A,less than 34 weeks of gestational age, n _1=30) and the older gestational age infants (the group B,34~41 weeks of gestational age, n _2=30).Results The serum concentrations of FT_3,FT_4,TSH showed a declining tendency in all neonates from the 1st day to the 7th day after birth.The serum concentrations of FT_3,FT_4 on the 1st and 7th day after birth were significantly higher in the controls than those in group A and group B,and those in group B were also significantly higher than those in group A.The serum TSH on the 1st and 7th day after birth were significantly higher in the controls than those in both group A and B,and those in group A were also significantly higher than those in group B.On the 7th day after birth,the serum TSH in group A were higher than those in group B and controls,whereas the serum TSH were not significantly different between group B and controls.Conclusion The thyroid function in the premature infants is transiently low.The shorter the gestational age,the lower the thyroid function and the longer the stress reaction.