Imamoglu E Y, Gursoy T, Hayran M, Karatekin G, Ovali F
Zeynep Kamil Maternity and Children's Training and Research Hospital, Neonatal Intensive Care Unit, Istanbul, Turkey.
Department of Pediatrics, School of Medicine, Koç University, Istanbul, Turkey.
J Perinatol. 2015 Mar;35(3):204-7. doi: 10.1038/jp.2014.181. Epub 2014 Oct 9.
The objective of this study was to help neonatologists to interpret the thyroid hormone results accurately, and also to provide reference ranges and/or nomograms of FT4 (free thyroxine) and thyrotropin against gestational age at postnatal 1 week and 1 month in order to assess thyroid function in AGA (appropriate for gestational age) neonates in intensive care unit.
This is a retrospective study. We included a total number of 515 AGA neonates between 24 and 42 weeks of gestation. Routine results of serum FT4 and TSH that had been analyzed with an immunoassay were collected from existing laboratory data. Least square regression analyses were used to estimate both the mean and the s.d. curves as polynomial functions of gestational age.
Free T4 levels were correlated with gestational age both at postnatal 1 week (r=0.39, P<0.001) and 1 month (r=0.26, P<0.001). Serum TSH levels at postnatal 1 week and 1 month did not show any correlation with gestational age. Scatterplots of FT4 levels against gestational age at 1 week and 1 month, showing the predicted 2.5th, 50th and 97.5th percentiles and central 95% reference ranges for TSH were provided.
Gestational age-specific nomograms for FT4 and reference ranges for TSH at postnatal 1 week and 1 month in AGA neonates have been developed. This can help neonatologists to interpret the thyroid hormone results accurately. Further studies providing reference ranges/nomograms for thyroid function in small-for-gestational-age neonates are needed.
本研究的目的是帮助新生儿科医生准确解读甲状腺激素结果，同时提供出生后1周和1个月时游离甲状腺素（FT4）和促甲状腺素针对胎龄的参考范围和/或列线图，以便评估重症监护病房中适于胎龄（AGA）新生儿的甲状腺功能。
这是一项回顾性研究。我们纳入了总共515例胎龄在24至42周之间的AGA新生儿。从现有的实验室数据中收集了用免疫分析法分析的血清FT4和促甲状腺激素（TSH）的常规结果。使用最小二乘回归分析来估计均值和标准差曲线，将其作为胎龄的多项式函数。
出生后1周（r = 0.39，P < 0.001）和1个月（r = 0.26，P < 0.001）时，游离T4水平均与胎龄相关。出生后1周和1个月时的血清TSH水平与胎龄均无相关性。提供了出生后1周和1个月时FT4水平相对于胎龄的散点图，显示了预测的第2.5、50和97.5百分位数以及TSH的中心95%参考范围。
已制定了AGA新生儿出生后1周和1个月时FT4的胎龄特异性列线图以及TSH的参考范围。这有助于新生儿科医生准确解读甲状腺激素结果。需要进一步开展研究，为小于胎龄新生儿的甲状腺功能提供参考范围/列线图。
