窒息新生儿甲状腺功能测定及临床意义

目的：探讨新生儿窒息后血清甲状腺激素的变化及其临床意义。方法：采用放射免疫法对50例窒息新生儿（轻度窒息组24例，重度窒息组26例）和40例正常新生儿（对照组）脐带血及生后3d静脉血中甲状腺激素三碘甲状腺原氨酸（T3）、促甲状腺激素（T4）及总甲状腺素（TSH）水平进行测定，对各组问及组内脐血、静脉血T3、T4、TSH水平进行比较。结果：（1）轻、重度窒息组新生儿生后3d静脉血T3、T4水平明显低于对照组（P〈0．01），而脐血及生后3d静脉血TSH水平均明显高于对照组（P〈0．01），并且重度窒息组生后3d静脉血TSH水平升高更明显（P〈0．01）。（2）生后3d静脉血和脐血自身前后对比，对照组T3、T4水平明显升高，TSH无明显改变，轻、重度窒息组T3、T4水平虽有下降，但差异无统计学意义（P〉0．05），而TSH水平则下降明显（P〈0．01）。结论：新生儿窒息后可出现甲状腺功能低下，血清甲状腺激素可作为窒息新生儿病情判断、疗效观察及预后估计的一项参考指标。

Determination and clinical significance of thyroid function in asphyxial neonates

Objective: To explore the changes and clinical significance of serum thyroid hormones in umbilical and venous blood 3 days after birth in asphyxial neonates.Methods: The concentrations of T_3,T_4 and TSH in serum of umbilical and venous blood 3 days after birth were tested by radioimmunoassay in 50 cases of asphyxial neonates and 40 cases of normal neonates,paired observation was carried out.Results:(1) The concentrations of serum T_3 and T_4 in venous blood 3 days after birth in the asphyxial neonate group were significantly decreased than those in normal control group(P<0.01).But concentrations of serum TSH in both umbilical and venous blood 3 days after birth in the asphyxial neonate group were significantly increased than those in normal contral group(P<0.01).(2) Compared with umbilical blood and venous blood 3 days after birth,the serum T_3,T_4 were significantly increased in normal control group,but decreased in asphyxial neonate group although had no significant difference.The serum TSH was significantly decreased in asphyxial neonate group and had no significant difference in normal control group.Conclusions: When the neonates have been asphyxiated,their thyroid function may be decreased.The concentrations of serum TSH in the asphyxial neonates are more sensitive than those of serum T_3 and T_4.It suggested that there was positive correlation between the increase of TSH and the severity of illness.Thus the determination of serum thyroid homones can be used as a reference index for judging the severity of illness,observation of theapeutic effect and estimation of prognosis in asphyxial neonates.