Kobayashi Akira, Usuda Touhei, Wada Masaki, Kaneko Takayuki, Kojima Kinuko, Saitoh Akihiko
General Center for Perinatal, Maternal and Neonatal Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan.
Department of Neonatology, Nagaoka Red Cross Hospital, Nagaoka, Japan.
Pediatr Int. 2018 May;60(5):433-437. doi: 10.1111/ped.13534. Epub 2018 Apr 18.
Thyroid function in asphyxiated newborns who received hypothermia therapy and its relation to neurological outcome are not well described.
We performed a prospective study to measure thyroid function in 12 asphyxiated newborns who received hypothermia therapy. We measured serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) on admission, at 24, 72, and 96 h after birth, and at discharge (range, 17-54 days). The 12 newborns were divided into two groups based on the presence of brain injury on head magnetic resonance imaging (six in the abnormal imaging group and six in the normal imaging group), and thyroid function was compared between the two groups.
Serum TSH was within the normal range in the 12 newborns. Serum FT3 and FT4 remained low at 24, 72, and 96 h after birth, and returned to normal range at discharge in the 12 newborns. There was no significant difference in serum TSH between the two groups, but serum FT3 at 96 h after birth, and serum FT4 at 72 and 96 h after birth, were significantly lower in the abnormal imaging group than in the normal imaging group (P = 0.02; P = 0.03; and P = 0.01, respectively).
Asphyxiated newborns have transient low thyroid hormone levels at 24-96 h after birth. Serum FT3 and FT4 between 72 and 96 h after birth may predict brain injury in asphyxiated newborns.
接受低温治疗的窒息新生儿的甲状腺功能及其与神经学转归的关系尚未得到充分描述。
我们进行了一项前瞻性研究,以测量12例接受低温治疗的窒息新生儿的甲状腺功能。在入院时、出生后24、72和96小时以及出院时(范围为17 - 54天)测量血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)。根据头部磁共振成像显示的脑损伤情况将这12例新生儿分为两组(异常成像组6例,正常成像组6例),并比较两组之间的甲状腺功能。
12例新生儿的血清TSH在正常范围内。12例新生儿出生后24、72和96小时血清FT3和FT4仍较低,出院时恢复至正常范围。两组之间血清TSH无显著差异,但异常成像组出生后96小时的血清FT3以及出生后72和96小时的血清FT4显著低于正常成像组(分别为P = 0.02;P = 0.03;P = 0.01)。
窒息新生儿在出生后24 - 96小时甲状腺激素水平短暂降低。出生后72至96小时的血清FT3和FT4可能预测窒息新生儿是否存在脑损伤。