Miao Ke-fan, Duan Wei, Qian Yan, Chen Da-qing
Neonatal Intensive Care Unit, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
Zhonghua Er Ke Za Zhi. 2013 Aug;51(8):607-11.
To investigate the influencing factors of transient hypothyroxinemia (THT) and low T3 syndrome (LT3S) in premature infants.
We have studied 418 premature infants whose gestational age was between 26 and 36 weeks.Serum thyronine (T4), triiodothyronine (T3) and thyrotropin (TSH) of them were detected on the fourteenth day approximately after birth. The patients were divided according to their serum T4, T3 and TSH into 3 groups (transient hypothyroxinemia, low T3 syndrome and normal). Then 20 Perinatal factors which may be associated with THT and LT3S were collected. The factors were analyzed by using Chi-square test and Logistic regression.
Forty-nine infants were found suffering from THT, 35 infants suffering from LT3S, and 334 infants in normal group. The prevalence rate of THT was 11.7%, and the prevalence rate of LT3S was 8.4%. Among the 20 factors, the factors related to the incidence of THT were male gender (OR = 1.863, 95%CI 0.966-3.594), albumin (OR = 2.401, 95%CI 1.294-4.455), dopamine (OR = 3.295, 95%CI 1.110-9.783) and those related to the incidence of LT3S were male gender (OR = 2.592, 95%CI 1.171-5.736), gestational age ≤ 28 wk (OR = 3.503, 95%CI 1.275-9.627).
Male gender, albumin and dopamine are perinatal risk factors of THT, meanwhile, male gender and gestational age ≤ 28 wk are perinatal risk factors of LT3S.With the use of risk factors identified in our study, it may be possible to separate infants having the highest risk of THT and LT3S, so as to form optimizing treatment strategies.
探讨早产儿短暂性甲状腺素血症(THT)及低T3综合征(LT3S)的影响因素。
研究418例孕周在26至36周之间的早产儿。在出生后约第14天检测其血清甲状腺素(T4)、三碘甲状腺原氨酸(T3)和促甲状腺激素(TSH)。根据血清T4、T3和TSH将患者分为3组(短暂性甲状腺素血症、低T3综合征和正常组)。然后收集20项可能与THT和LT3S相关的围产期因素。采用卡方检验和Logistic回归分析这些因素。
发现49例婴儿患有THT,35例婴儿患有LT3S,334例婴儿为正常组。THT的患病率为11.7%,LT3S的患病率为8.4%。在这20项因素中,与THT发生率相关的因素有男性(OR = 1.863,95%CI 0.966 - 3.594)、白蛋白(OR = 2.401,95%CI 1.294 - 4.455)、多巴胺(OR = 3.295,95%CI 1.110 - 9.783);与LT3S发生率相关的因素有男性(OR = 2.592,95%CI 1.171 - 5.736)、孕周≤28周(OR = 3.503,95%CI 1.275 - 9.627)。
男性、白蛋白和多巴胺是THT的围产期危险因素,同时,男性和孕周≤28周是LT3S的围产期危险因素。利用本研究确定的危险因素,有可能区分出THT和LT3S风险最高的婴儿,从而制定优化的治疗策略。