Hyman Sharon J, Greig Fenella, Holzman Ian, Patel Arti, Wallach Elizabeth, Rapaport Robert
Division ofPediatric Endocrinology and Diabetes, Mount Sinai School of Medicine, New York, NY 10029, USA.
J Pediatr Endocrinol Metab. 2007 Apr;20(4):501-10. doi: 10.1515/jpem.2007.20.4.501.
To determine the frequency and characteristics of late rise of thyroid stimulating hormone (LRT) among ill newborns.
Data were retrospectively analyzed from infants in intensive care settings with abnormal thyroid tests over 13 months. Thyroid tests were performed by filter paper if neonatal intensive care >4 weeks or serum if clinically indicated. LRT was defined as thyroid stimulating hormone (TSH) >10 microIU/ml after normal TSH on initial newborn screen.
LRT was identified in 13 infants. Of 736 admissions to the neonatal intensive care unit (NICU), 10 (1.4%) had LRT. Excluding 3/10 with diagnosis at <1 week of age the frequency is 0.95%. Three additional cases occurred in other ICUs. TSH elevation resolved in 6/13 (group A, TSH 10.6-20.6 microIU/ml) and persisted in 7/13 necessitating treatment (group B, TSH 10.5-1326 microIU/ml). 7/13 had birth weights <1500 g. 11/13 had gestational ages <37 weeks. LRT was associated with surgery, sepsis workup, dopamine, and gastrointestinal disorders.
LRT was not infrequent in ill newborns. Most were premature and half were not very low birth weight. We recommend monitoring of thyroid function by serum specimen in ill newborns with prolonged ICU care regardless of birth weight.
确定患病新生儿中促甲状腺激素延迟升高（LRT）的频率及特征。
回顾性分析了13个月内重症监护病房中甲状腺检查异常的婴儿的数据。如果新生儿重症监护时间>4周，则通过滤纸进行甲状腺检查；如果临床有指征，则进行血清检查。LRT定义为新生儿初次筛查时促甲状腺激素（TSH）正常，之后TSH>10微国际单位/毫升。
13例婴儿被确定为LRT。在736例入住新生儿重症监护病房（NICU）的患儿中，10例（1.4%）出现LRT。排除1周龄内确诊的3/10病例后，频率为0.95%。另外3例发生在其他重症监护病房。6/13的TSH升高得到缓解（A组，TSH 10.6 - 20.6微国际单位/毫升），7/13持续存在，需要治疗（B组，TSH 10.5 - 1326微国际单位/毫升）。7/13出生体重<1500克。1
