早产儿暂时性低甲状腺素血症的临床观察

目的: 探讨早产儿暂时性低甲状腺素血症(transient hyPothyroxinemia of Prematurity,THP)发病情况,并对其早期生活质量进行量化观察。方法: 将125例早产儿按是否合并其他疾病分成早产儿单纯生活能力低下为生观察组(A组,n=56)和合并其他疾病组(B组,n=69);同期出生的62名正常足月儿作为对照组(C组)。应用电化学发光法检测3组新生儿生后第1、7天静脉血促甲状腺激素(TSH)、总甲状腺素(TT4)、总三碘甲状腺原氨酸(TT3),并对THP组和非THP组早产儿的早期生活质量进行量化观察。结果: 早产儿THP发病率为62.4%。3组新生儿TSH、TT4、TT3第7天水平均低于第1天,A、B组均相应低于对照组(P < 0.01);B组第1天与A组差异均无统计学意义(P < 0.01),第7天TT4低于A组(P < 0.01)。3组新生儿TT4/TSH第1天差异无统计学意义(P > 0.05),第7天对照组、A组、B组依次降低(P < 0.01)。THP组早产儿需氧、规则自行排便、高胆红素血症持续、热量达418.4 kJ·kg-1·d-1、恢复出生体重日龄及住院时间均较非THP组显著延迟(P < 0.01)。结论: 早产儿下丘脑-垂体-甲状腺轴发育不成熟,生后甲状腺功能可降低,危重早产儿甲状腺功能下降更明显,且降低了早产儿早期生活质量。

Clinical observation of transient hypothyroxinemia in premature infants

Objective:To probe into the incidence of transient hypothyroxinemia(THP) in premature infants and to observe their early quality of life.Methods:One hundred and twenty-five hospitalized premature infants were divided into two groups.Group A included 56 premature infants with no other diseases,group B included 69 premature infants who were accompanied by other diseases,and 62 normal neonates acted as control.Electrochemistry luminescence was used to detect the blood thyroid-stimulating hormone(TSH),total thy...