新生儿重症监护病房中的甲状腺功能

Thyroid Function in the Neonatal Intensive Care Unit.

作者信息

Chaudhari Monika, Slaughter Jonathan L

机构信息

Department of Pediatrics, Division of Endocrinology, Nationwide Children's Hospital, The Ohio State University, 700 Children's Crossroad, Columbus, OH 43205, USA.

Department of Pediatrics, Division of Neonatology, Center for Perinatal Research, Nationwide Children's Hospital, The Ohio State University, Research 3 Building, 575 Children's Crossroad, Columbus, OH 43215, USA.

出版信息

Clin Perinatol. 2018 Mar;45(1):19-30. doi: 10.1016/j.clp.2017.10.005. Epub 2017 Dec 13.

DOI:10.1016/j.clp.2017.10.005

PMID:29406004

Abstract

Patients in the neonatal intensive care unit (NICU) are at high risk for abnormal thyroid function testing because of illness and preterm birth. Preterm infants are born before hypothalamic-pituitary-thyroid axis maturation and the normal feedback mechanisms that regulate thyroid hormone production remain immature. Preterm and sick infants may develop hypothyroidism even if routine thyroid screening tests collected in the first several days after birth are normal. This article reviews normal hypothalamic-pituitary-thyroid axis maturation, thyroid hormone testing and interpretation in the NICU, and the current evidence for and against levothyroxine treatment of NICU patients with borderline abnormal thyroid function testing.

摘要

由于患病和早产，新生儿重症监护病房（NICU）的患者甲状腺功能测试异常的风险很高。早产儿在丘脑-垂体-甲状腺轴成熟之前出生，调节甲状腺激素产生的正常反馈机制仍不成熟。即使出生后头几天进行的常规甲状腺筛查测试正常，早产和患病婴儿也可能发生甲状腺功能减退。本文综述了丘脑-垂体-甲状腺轴的正常成熟过程、NICU中的甲状腺激素检测与解读，以及支持和反对对甲状腺功能测试临界异常的NICU患者使用左甲状腺素治疗的现有证据。