Lucas A, Rennie J, Baker B A, Morley R
MRC Dunn Nutrition Unit, Cambridge.
Arch Dis Child. 1988 Oct;63(10):1201-6. doi: 10.1136/adc.63.10.1201.
A major association has been found between low plasma triiodothyronine concentrations in preterm neonates and their later developmental outcome. Plasma triiodothyronine concentration was measured longitudinally in 280 preterm infants below 1850 g birth weight. Babies whose lowest recorded concentration was less than 0.3 nmol/l had, at 18 months' corrected age, 8.3 and 7.4 point disadvantages in Bayley mental and motor scales and a 8.6 point disadvantage on the academic scale of Developmental Profile II, even after adjusting for a range of antenatal and neonatal factors known to influence later development. Low concentrations of triiodothyronine were strongly associated with infant mortality, but not after adjusting for the presence of respiratory illness. There was no association between plasma triiodothyronine concentrations and somatic growth up to 18 months, and no association with necrotising enterocolitis or later cerebral palsy. Data on postnatal changes in plasma triiodothyronine concentrations are presented for reference purposes. While cited reference ranges for plasma triiodothyronine concentration appear suitable for well infants above 1500 g birth weight, smaller or ill babies often have very low values for many weeks. Our data are relevant to the debate on endocrine 'replacement' treatment in premature babies.
已发现早产新生儿血浆三碘甲状腺原氨酸浓度低与其后期发育结局之间存在主要关联。对280名出生体重低于1850克的早产婴儿进行了血浆三碘甲状腺原氨酸浓度的纵向测量。记录到的最低浓度低于0.3纳摩尔/升的婴儿，在矫正年龄18个月时，即使在对一系列已知会影响后期发育的产前和新生儿因素进行调整后，在贝利智力和运动量表上仍有8.3分和7.4分的劣势，在发育概况II学业量表上有8.6分的劣势。三碘甲状腺原氨酸浓度低与婴儿死亡率密切相关，但在对是否存在呼吸道疾病进行调整后则不然。血浆三碘甲状腺原氨酸浓度与18个月前的身体生长无关，与坏死性小肠结肠炎或后期脑瘫也无关。给出了血浆三碘甲状腺原氨酸浓度产后变化的数据以供参考。虽然引用的血浆三碘甲状腺原氨酸浓度参考范围似乎适用于出生体重超过1500克的健康婴儿，但较小或患病的婴儿通常在数周内数值都很低。我们的数据与关于早产儿内分泌“替代”治疗的争论相关。
