胎龄和日龄对早产儿甲状腺功能指标的影响

doi:10.11852/zgetbjzz2020-2037

中国儿童保健杂志 ›› 2021, Vol. 29 ›› Issue (8): 910-913.DOI: 10.11852/zgetbjzz2020-2037

胎龄和日龄对早产儿甲状腺功能指标的影响

黄循斌¹, 周秋婧¹, 符青松¹, 程国强², 丘惠娴¹

1.深圳市龙岗中心医院新生儿科,广东深圳 518116;
2.复旦大学附属儿科医院新生儿科

收稿日期:2020-11-26 修回日期:2021-05-24 发布日期:2021-08-24 出版日期:2021-08-10
通讯作者: 程国强,E-mail:gqchengcm@163.com
作者简介:黄循斌(1980-),男,海南人,副主任医师,硕士研究生,主要研究方向为新生儿危重症。

Influence of gestational age and postnatal age on thyroid function of preterm infants

HUANG Xun-bin^*, ZHOU Qiu-jing, FU Qing-song, CHENG Guo-qiang, QIU Hui-xian

^*Department of Neonatology, Longgang District Central Hospital of Shenzhen, Shenzhen, Guangdong 518116, China

Received:2020-11-26 Revised:2021-05-24 Online:2021-08-10 Published:2021-08-24
Contact: CHENG Guo-qiang, E-mail: gqchengcm@163.com

摘要/Abstract

摘要： 目的分析胎龄和日龄对早产儿甲状腺功能的影响,为进一步研究基于胎龄和日龄制定适用于早产儿的甲状腺功能参考区间。方法收集2017年5月—2020年5月在深圳市龙岗中心医院新生儿科住院早产儿的甲状腺功能指标[促甲状腺激素(TSH)、甲状腺素(T₄)、游离甲状腺素(FT₄)和三碘甲状腺原氨酸(T₃)]结果。按照胎龄和生后日龄分组,对比各组早产儿甲状腺功能指标水平,并分析各检测指标随胎龄和生后日龄的变化。结果共纳入符合条件的早产儿497例,其中早期早产儿组206例、中期早产儿组128例和晚期早产儿组163例。1)早期早产儿组甲状腺功能指标分别与中期、晚期早产儿组比较,差异有统计学意义(P＜0.05);中期早产儿组甲状腺功能指标与晚期早产儿组比较,差异无统计学意义(P＞0.05)。2)各胎龄组早期早产儿T₄、FT₄和T₃水平比较,差异有统计学意义(H=36.588、32.381、43.021,P＜0.01),TSH水平差异无统计学意义(P＞0.05)。3)生后日龄7~14 d组与14~28 d组早产儿T₄、FT₄和T₃水平比较,差异有统计学意义(Z＝8.706、6.904、9.497,P＜0.05),而血清TSH比较,差异无统计学意义(P＞0.05)。4)早产儿T₄、FT₄、T₃水平与胎龄、日龄呈正相关性,而TSH 水平与胎龄、日龄之间均无相关性。结论早期早产儿T₄、FT₄、T₃水平与胎龄、日龄呈正相关,需基于胎龄和日龄制定适用于早产儿的甲状腺功能参考区间。

关键词: 甲状腺功能, 早产儿, 胎龄, 日龄

Abstract: Objective To analyze the influence of gestational age and postnatal age on thyroid function indexes in premature infants, in order to establish a reference interval for thyroid function for premature infants based on gestational age and postnatal age. Methods The levels of thyroid stimulating hormone (TSH), thyroxine (T4), free thyroxine (FT4) and triiodothyronine (T3) of premature infants in neonatal department of Longgang Central Hospital from May 2017 to May 2020 were collected. Infants were divided into early preterm infants, mid-term premature infants and late premature infants according to gestational age and postnatal age. The levels of thyroid function index in each group were compared, and the changes of each index with gestational age and postnatal age were analyzed. Results A total of 497 premature infants were included. The early, mid-term and late premature infants were 206, 128, and 163 cases, respectively. 1) The levels of thyroid function indexes of early premature infants were significantly different from those of mid-late and late preterm infants(P＜0.05), but the difference was not significant between mid-late and late preterm infants(P＞0.05). 2) The T₄, FT₄ and T₃ levels of early preterm infants were significantly different among infants with different gestational ages(H=36.588, 32.381, 43.021, P<0.05), while the significant difference was not found in TSH level(P＞0.05). 3)The T₄, FT₄and T₃ levels of premature infants were significantly different between 7—14 days group and 14—28 days group (Z=8.706, 6.904, 9.497,P＜0.05), but the significant difference was not found in TSH level(P＞0.05). 4) The T₄, FT₄, T₃ level of premature infants was positively correlated with gestational age and postnatal age, but the correlation was not significant between TSH level and gestational age and postnatal age. Conclusion The levels of T₄, FT₄ and T₃ in early preterm infants are positively correlated with gestational age and postnatal age, so the reference interval of thyroid function for preterm infants should be established based on gestational age and postnatal age.

Key words: thyroid function, preterm infant, gestational ages, postnatal age

中图分类号:

R722.6

黄循斌, 周秋婧, 符青松, 程国强, 丘惠娴. 胎龄和日龄对早产儿甲状腺功能指标的影响[J]. 中国儿童保健杂志, 2021, 29(8): 910-913.

HUANG Xun-bin, ZHOU Qiu-jing, FU Qing-song, CHENG Guo-qiang, QIU Hui-xian. Influence of gestational age and postnatal age on thyroid function of preterm infants[J]. Chinese Journal of Child Health Care, 2021, 29(8): 910-913.

参考文献

[1] Bernal J. Thyroid hormones and braindevelopment[J]. Vitam Horm, 2005, 71:95-122.
[2] Goissen C, Fontaine C, Braun K, et al. Prospective study at week of life of thyroid function in 97 consecutive pre-term newborns under 32 weeks of gestation[J]. Arch Pediatr, 2011, 18(3):253-260.
[3] 刘燕, 姜红. 早产儿暂时性低甲状腺素血症的研究进展[J]. 中国新生儿科杂志, 2015, 30(4):306-307.
[4] La Gamma EF, van Wassenaer AG, Ares S, et al. Phase 1 trial of 4 thyroid hormone regimens for transient hypothyroxinemia in neonates of <28 weeks' gestation[J]. Pediatrics, 2009, 124(2):e258-e268.
[5] 杨海河, 裘蕾, 赵金琦, 等. 1989-2014 年北京市先天性甲状腺功能减低症发病特征及影响因素分析[J]. 中华预防医学杂志, 2016, 50(8):728-732.
[6] 王琼, 齐志业, 赵小龙, 等. 云南省6州/市先天性甲状腺功能减低症筛查中TSH 切值的确立[J]. 昆明医科大学学报, 2018, 39(1):69-72.
[7] Mitrovic K, Vukovic R, Milenkovic T, et al. Changes in the incidence and etiology of congenital hypothyroidism detected during 30 years of a screening program in central Serbia[J]. Eur J Pediatr, 2016, 175(2):253-259.
[8] Korevaar TI, Muetzel R, Medici M, et al. Association of maternal thyroid function during early pregnancy with offspring IQ and brain morphology in childhood: a population-based prospective cohort study[J]. Lancet Diabetes Endo, 2016, 4(1):35-43.
[9] 程琼, 杨妙琳, 张竞文. 新生儿甲状腺功能指标生物参考区间的建立及验证研究[J]. 中国医学创新, 2019, 16(25):40.
[10] Kucharska AM, Beń-Skowronek I, Walczak M, et al. Congenital hypothyroidism-Polish recommendations for therapy, treatment monitoring, and screening tests in special categories of neonates with increased risk of hypothyroidism[J]. Endokrynol Pol, 2016, 67(5):536-547.
[11] Dandamrongrak P, Chawanpaiboon S. Correlation between iodine supplement in pregnancy and neonatal TSH level[J]. J Med Assoc Thai, 2016, 99(12):1257-1262.
[12] Chauvet P, Terral D, Colombier M, et al. Iodinated contrast in pregnant women and neonatal thyroid function[J]. Gynecol Obstet Fertil, 2016, 44(12): 685-689.
[13] 王睿, 孙美荣, 孔维康, 等. 不同胎龄早产儿甲状腺素功能的检测[J]. 精准医学杂志, 2019, 34(4):316.
[14] 邵肖梅, 叶鸿瑁, 丘小汕. 早产儿暂时性甲状腺功能减退[M]//实用新生儿学.5版.北京:人民卫生出版社,2019:922-923.
[15] Hume R, Simpson J, Delahunty C, et al. Human fetal and cord serum thyroid hormones: developmental trends and inter-relationships[J]. J Clin Endocrinol Metab, 2004, 89(8): 4097-4103.
[16] Biswas S, Buffery J, Enoch H, et al. A longitudinal assessment of thyroid hormone concentrations in preterm infants younger than 30 weeks'gestation during the first 2 weeks of life and their relationship to outcome[J]. Pediatrics, 2002, 109(2):222-227.
[17] Bijarnia S, Wilcken B, Wiley VC. Newborn screening for congenital hypothyroidism in very-low-birth-weight babies: the need for a second test[J]. J Inherit Metab Dis, 2011, 34(3): 827-833.
[18] Woo HC, Lizarda A, Tucker R, et al. Congenital hypothyroidism with a delayed thyroid-stimulating hormone elevation in very premature infants: incidence and growth and developmental outcomes[J]. J Pediatr, 2011, 158(4): 538-542.

胎龄和日龄对早产儿甲状腺功能指标的影响

Influence of gestational age and postnatal age on thyroid function of preterm infants

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	李茗竹, 王静, 谢多双. 小于胎龄儿过快追赶生长与儿童期肥胖关系的研究[J]. 中国儿童保健杂志, 2023, 31(7): 751-755.
[2]	张丹, 张军, 杨钰荣, 曹咪, 闫敬敏, 朱璐阳. 肠道菌群与早产儿脑发育及神经认知行为关系的研究[J]. 中国儿童保健杂志, 2023, 31(7): 756-759.
[3]	潘婷, 张萱. 双胎小于胎龄儿生长发育及影响因素的研究进展[J]. 中国儿童保健杂志, 2023, 31(7): 760-765.
[4]	冯骁, 陈凌, 赵红缨, 黄蕊, 林辰曦, 庄丽娟. 不同脐带挤压方式对极早产儿结局的影响[J]. 中国儿童保健杂志, 2023, 31(7): 794-798.
[5]	郑亭玉, 张春宇, 杨飞, 郑芳, 张梦霞, 夏露萍, 徐孙超. 营养支持小组管理模式对早产儿生长发育及免疫功能的影响[J]. 中国儿童保健杂志, 2023, 31(5): 555-558.
[6]	王晓庆, 刘九月, 姚光. 小于胎龄儿早期脑发育及18~24月龄时神经发育状况的前瞻性队列研究[J]. 中国儿童保健杂志, 2023, 31(4): 353-358.
[7]	夏正龙, 宋燕燕. 支气管肺发育不良早产儿神经发育研究[J]. 中国儿童保健杂志, 2023, 31(4): 390-394.
[8]	李静兰, 孙文强, 朱雪萍. 早产儿支气管肺发育不良相关预测模型研究[J]. 中国儿童保健杂志, 2023, 31(4): 395-398.
[9]	王娜, 李晓莺. 早产儿神经发育评估的进展[J]. 中国儿童保健杂志, 2023, 31(4): 404-407.
[10]	任力, 黑明燕, 齐宇洁, 靳绯, 翁景文, 董世霄, 沈艳华, 姜敏. 早产儿喂养对坏死性小肠结肠炎发病的影响[J]. 中国儿童保健杂志, 2023, 31(4): 438-441.
[11]	陈峰, 张宇. 多胞胎和单胞胎早产儿神经发育的回顾性研究[J]. 中国儿童保健杂志, 2023, 31(4): 451-456.
[12]	王晶, 项思嘉, 鲁莹, 杨蕾, 胡小沙, 钱君, 池霞, 张敏. 早产儿3周岁体格生长及体成分分析[J]. 中国儿童保健杂志, 2023, 31(4): 457-460.
[13]	郑水英, 罗艳赟. 早产儿喂养不耐受的临床表现及相关影响因素[J]. 中国儿童保健杂志, 2023, 31(4): 461-464.
[14]	曹冰冰, 林多华, 杜佩珍, 颜陶, 程建婷. 多种实验室指标和炎性因子表达水平与新生儿神经发育的相关性研究[J]. 中国儿童保健杂志, 2023, 31(2): 205-209.
[15]	何小颖, 吴翠玲, 曾玲艳, 綦美姣, 孙亚莲. 早产儿食物转换对血清营养素水平的影响[J]. 中国儿童保健杂志, 2023, 31(1): 81-85.