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短暂性甲状腺素血症是否会影响早产儿的代谢性骨病?

Does transient hypothyroxinemia influence metabolic bone disease of prematurity?

作者信息

Demirel Utku, Özek Eren, Bereket Abdullah, Demirel Bilge, Topuzoğlu Ahmet, Akman İpek

机构信息

Department of Neonatology, Bahcesehir University Hospital , Istanbul , Turkey .

出版信息

J Matern Fetal Neonatal Med. 2013 Dec;26(18):1844-9. doi: 10.3109/14767058.2013.804051. Epub 2013 Jul 26.

Abstract

OBJECTIVE

To investigate the relationship between Metabolic Bone Disease (MBD) and Transient Hypothyroxinemia of Prematurity (THOP).

METHOD

One hundred twenty-four infants, born in Marmara University Hospital with a gestational age ≤34 weeks, were enrolled. Clinical features were recorded. Serum TSH, free T4, total T4, calcium, phosphorus and total Alkaline Phosphatase (ALP) levels were determined in the first and third postnatal weeks. MBD was defined as a phosphorus level <4.5 mg/dl and/or ALP >900 IU/l. THOP was defined as a serum free and/or total thyroxine level lower than -1 SD for gestational age at the 7th postnatal day.

RESULT

THOP was diagnosed in nineteen (15.3%) patients. MBD was diagnosed in 52 (41.9%) at the 3rd month. Low birth weight, low gestational age and prolonged parenteral nutrition were associated with MBD. Multivariate analysis documented a significant relationship solely between MBD and gestational age.

CONCLUSION

The risk of MBD does not increase significantly in babies with THOP.

摘要

目的

探讨代谢性骨病(MBD)与早产儿短暂性甲状腺素血症(THOP)之间的关系。

方法

纳入124例在马尔马拉大学医院出生、胎龄≤34周的婴儿。记录临床特征。在出生后第一周和第三周测定血清促甲状腺激素(TSH)、游离甲状腺素(T4)、总甲状腺素、钙、磷和总碱性磷酸酶(ALP)水平。MBD定义为磷水平<4.5mg/dl和/或ALP>900IU/l。THOP定义为出生后第7天血清游离和/或总甲状腺素水平低于胎龄的-1标准差。

结果

19例(15.3%)患者被诊断为THOP。3个月时52例(41.9%)被诊断为MBD。低出生体重、低胎龄和长期肠外营养与MBD相关。多因素分析表明,仅MBD与胎龄之间存在显著关系。

结论

THOP婴儿发生MBD的风险没有显著增加。

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