Fisher Delbert A
David Geffen School of Medicine at UCLA, USA.
Semin Perinatol. 2008 Dec;32(6):387-97. doi: 10.1053/j.semperi.2008.09.003.
Continuing advances in the care of premature infants has contributed to the increased survival of very low birth weight premature infants. These infants are characterized by a variety of organ and physiological systems immaturities predisposing to deficiencies of postnatal adaptation and a high prevalence of neonatal morbidities. These morbidities have a major impact on postnatal mental and neurological outcomes. Thyroid hormones play a critical role in central nervous system development and function, and thyroid system immaturities as well as morbidity-related thyroid dysfunction (the nonthyroidal illness syndrome) contribute to the transient hypothyroxinemia of premature infants (THOP). Several studies have demonstrated a correlation of THOP with subsequent low IQ and neurologic sequelae in very low birth weight premature infants, and there is suggestive evidence that thyroid hormone supplementation in very low birth weight infants can improve mental outcome. Here, we review normal fetal thyroid system development and the system immaturities contributing to THOP and predisposing to nonthyroidal illness in very low birth weight infants.
早产儿护理方面的持续进步促使极低出生体重早产儿的存活率提高。这些婴儿的特点是各种器官和生理系统不成熟，易导致出生后适应能力不足以及新生儿疾病的高发病率。这些疾病对出生后的心理和神经学结局有重大影响。甲状腺激素在中枢神经系统发育和功能中起关键作用，甲状腺系统不成熟以及与疾病相关的甲状腺功能障碍（非甲状腺疾病综合征）导致早产儿出现短暂性低甲状腺素血症（THOP）。多项研究表明，THOP与极低出生体重早产儿随后的低智商和神经后遗症相关，并且有提示性证据表明，对极低出生体重婴儿补充甲状腺激素可改善心理结局。在此，我们综述正常胎儿甲状腺系统发育以及导致THOP并使极低出生体重婴儿易患非甲状腺疾病的系统不成熟情况。
