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目的探讨不同胎龄早产儿甲状腺功能特点及其影响因素。方法选择本院新生儿科2012年1~12月收治的早产儿为研究对象。按胎龄分为28~31周组、32~34周组及35~36周组,选取同期本院产科出生的健康足月新生儿30名为对照组。分别在生后第1天和第14天检测新生儿静脉血血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)以及促甲状腺激素(TSH),并分析其影响因素。结果各组新生儿生后14天血清FT3、FT4、TSH水平均显著低于生后第1天(P<0.05)。35~36周组和对照组生后第1、14天血清FT3、FT4水平均高于28~31周组和32~34周组,32~34周组高于28~31周组(P<0.05)。TSH水平生后第1天35~36周组和对照组高于28~31周组和32~34周组,生后第14天28~31周组和32~34周组高于35~36周组和对照组(P<0.05)。早产儿生后第1天影响甲状腺功能的因素为胎龄、出生体重及窒息、缺氧缺血性脑病、呼吸窘迫征综合征、休克等严重疾病;生后第14天影响因素为胎龄和出生体重。结论早产儿下丘脑-垂体-甲状腺轴发育不成熟,生后14天检测甲状腺功能具有重要临床意义。
Objective To investigate the thyroid function and its influencing factors in preterm infants of different gestational ages. Methods Select the premature infants admitted to our hospital from January 2012 to December 2012 as the research object. According to gestational age was divided into 28 to 31 weeks group, 32 to 34 weeks group and 35 to 36 weeks group, select the hospital obstetric birth of healthy full-term newborns 30 as control group. The levels of free triiodothyronine (FT3), free thyroid hormone (FT4) and thyroid stimulating hormone (TSH) in neonatal venous blood were detected on the first day and the fourteenth day after birth, and the influencing factors were analyzed. Results The serum levels of FT3, FT4 and TSH in neonates after 14 days of birth were significantly lower than those on the first day after birth (P <0.05). The levels of FT3 and FT4 in serum of 35-36 weeks group and control group were higher than those of 28-31 weeks group and 32-34 weeks group on the 1st and 14th days after birth, and those of the 32-34 weeks group were higher than those of the 28-31 weeks group (P < 0.05). TSH levels 35-36 weeks after birth in the first 35 days of the group and the control group 28-31 weeks group and 32-34 weeks group 14 days after birth 28-31 weeks group and 32-34 weeks group was higher than 35-36 Week group and control group (P <0.05). Preterm infants on the first day after birth factors that affect thyroid function are gestational age, birth weight and asphyxia, hypoxic ischemic encephalopathy, respiratory distress syndrome, shock and other serious diseases; the first 14 days after birth factors affecting gestational age and Birth weight. Conclusions The hypothalamus - pituitary - thyroid axis in preterm infants is immature and the detection of thyroid function 14 days after birth has important clinical significance.