l'Allemand D, Grüters A, Beyer P, Weber B
Department of Pediatrics, Free University of Berlin.
Horm Res. 1987;28(1):42-9. doi: 10.1159/000180924.
In 51 sick newborns the influence of two different nonionic, iodine-containing contrast agents, Amipaque (group 1) and Omnipaque (group 2) and of long-term treatment with polyvinylpyrrolidone-iodine (PVP-I) (group 3) on thyroid function was studied. In the dose given, freshly dissolved Amipaque releases roughly 100 micrograms 'free' iodide/kg body weight; this release may be even higher in the solubilized agent Omnipaque because of increased breakdown. Urinary iodine excretion was elevated in all groups on day 5 after iodine exposure. In group 1, which included 17 term newborns, the median TSH level was normal after 5 days and 2 weeks, only 1 case of transient hypothyrotropinemia was observed; T4 and T3 median levels were in the lower range of normal. In groups 2 and 3, which included 8 preterm infants of 15 newborns and 9 preterm infants of 19 newborns, respectively, the median TSH values were elevated and T4 and T3 levels were very low. Hypothyroidism was diagnosed in 6 of the 8 preterm and in 1 of the 7 term newborns of group 2. In group 3, 7 of the 9 preterm and 3 of the 10 term newborns reacted with hypothyroidism. Eight preterm and 3 term newborns had to be substituted with thyroxine. The thyroid function of term newborns was less affected by Amipaque or Omnipaque than by PVP-I. The data show that preterm infants are very sensitive to an iodine load.
研究了51例患病新生儿中两种不同的非离子型含碘造影剂（甲组为阿米培克，乙组为欧乃派克）以及聚乙烯吡咯烷酮碘（PVP-I）长期治疗（丙组）对甲状腺功能的影响。按给定剂量，新溶解的阿米培克每千克体重可释放约100微克“游离”碘化物；由于分解增加，在溶解剂欧乃派克中这种释放量可能更高。碘暴露后第5天，所有组的尿碘排泄均升高。甲组包括17例足月儿，5天和2周后促甲状腺激素（TSH）水平中位数正常，仅观察到1例短暂性促甲状腺激素血症；甲状腺素（T4）和三碘甲状腺原氨酸（T3）水平中位数在正常范围下限。乙组分别包括15例新生儿中的8例早产儿和丙组包括19例新生儿中的9例早产儿，TSH值中位数升高，T4和T3水平非常低。乙组8例早产儿中有6例以及7例足月儿中有1例被诊断为甲状腺功能减退。丙组9例早产儿中有7例以及10例足月儿中有3例出现甲状腺功能减退反应。8例早产儿和3例足月儿必须用甲状腺素替代治疗。足月儿的甲状腺功能受阿米培克或欧乃派克的影响小于受PVP-I的影响。数据表明，早产儿对碘负荷非常敏感。
