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健康足月儿、低出生体重儿和早产儿的甲状腺功能

Thyroid function in healthy normal, low birthweight and preterm infants.

作者信息

Bongers-Schokking J J, Schopman W

出版信息

Eur J Pediatr. 1984 Dec;143(2):117-22. doi: 10.1007/BF00445798.

Abstract

To delineate more precisely the role of gestational age, weight at birth and thyroid status at birth on the postnatal changes in thyroid hormone levels, serum T4, T3, TSH and in some cases FT3I were measured at birth and at 3-4 h, 24-30 h, 6-9 days and 13-20 days. Subjects studied were healthy appropriate-for-date (AFD) and small-for-date (SFD) term neonates and healthy AFD and SFD preterm children. At birth T4 and T3 are related to both gestational age and weight with T4 and T3 showing lower values in preterm and SFD term neonates than in AFD term children. After birth T4 and T3 concentrations show a better correlation with gestational age than with weight at birth. For TSH no correlation was found at birth, a positive correlation at 24-30 h, no correlation at 6-9 days and a negative correlation at 13-20 days both with gestational age and weight at birth. In term and close-to-term infants (36 weeks) individual T4 levels at 6-7 days show a close relationship with those at birth; in the younger children (34 and 35 weeks) lower T4 values are found, despite equal cord blood values. The individual cord blood FT3I/TSH values correlate well with those at 6-7 days of age. It is concluded that after birth all children have changing T4 and T3 values, but the pattern and level are influenced by the maturity of the child and its thyroid status at birth measured by T4 and by the FT3I/TSH ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为了更精确地描述胎龄、出生体重和出生时甲状腺状态对出生后甲状腺激素水平变化的作用,在出生时、3 - 4小时、24 - 30小时、6 - 9天和13 - 20天测量了血清总甲状腺素(T4)、总三碘甲状腺原氨酸(T3)、促甲状腺激素(TSH),某些情况下还测量了游离甲状腺指数(FT3I)。研究对象为健康的足月儿(适于胎龄儿,AFD)和小于胎龄儿(SFD)以及健康的早产AFD和SFD儿童。出生时,T4和T3与胎龄和体重均相关,早产和SFD足月儿的T4和T3值低于AFD足月儿。出生后,T4和T3浓度与胎龄的相关性比与出生体重的相关性更好。对于TSH,出生时未发现相关性,24 - 30小时呈正相关,6 - 9天无相关性,13 - 20天与胎龄和出生体重均呈负相关。足月儿和近足月儿(36周)6 - 7天时的个体T4水平与出生时密切相关;在较小的儿童(34和35周)中,尽管脐血值相同,但T4值较低。个体脐血FT3I/TSH值与6 - 7日龄时的值相关性良好。结论是,出生后所有儿童的T4和T3值都在变化,但模式和水平受儿童成熟度及其出生时甲状腺状态(通过T4和FT3I/TSH比值衡量)的影响。(摘要截选至250词)

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