早产儿暂时性甲状腺功能低下替代治疗临床研究进展

早产儿暂时性甲状腺功能低下(THOP)发生率高,是否给予甲状腺素替代治疗存在分歧.有关THOP的临床研究提示,THOP甲状腺素替代治疗不能降低病死率、呼吸疾病发生率,可降低动脉导管未闭的发生率.胎龄小于28周THOP早产儿给予甲状腺素替代治疗可能改善神经发育预后,胎龄大于28周不能改善神经发育.未来研究应按胎龄确定早产儿甲状腺素正常值;设计良好的根据胎龄分层的临床随机研究,以明确甲状腺素替代治疗对远期神经发育的影响.

Clinical trials with thyroid hormone supplementation in preterm infants with transient hypothyroidism

The morbidity of transient hypothyroxinemia of prematurity (THOP) was high. There is controversial about thyroid hormone supplementation in THOP. Clinical studies suggest that thyroid hormone supplementation can reduce the incidence of patent ductus arteriosus,but no effect on the mortality and the incidence of respiratory disease.Thyroid hormone supplementation can improve the neurodevelopmental outcomes in infants with gestational age less than 28 weeks with THOP, but no effect on infants with gestational age more than 28 weeks. Future research should focus on the normal range of thyroid hormone according to gestational age in preterm infants,and randomized clinical trial welldesigned stratified according to gestational age to study the long-term neurodevelopmental outcome of thyroid hormone replacement therapy in infants with THOP