Shi L X, Ma Q L, Zhang J X
Affilitated Hospital of Guiyang Medical College, Guizhou.
Zhonghua Fu Chan Ke Za Zhi. 1994 Dec;29(12):714-6, 760-1.
The present study was designed to explore the influence of perinatal factors and sampling methods on fetal pituitary-thyroid axis. The results showed: (1) There was no linear relation between cord serum thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4) and either birth weight or the duration of labor (r = 0.03-0.12, P > 0.05). The mean cord serum TSH, T3 or T4 levels in the fetus delivered with uterotonic agents were no significant difference from those in fetus without these drugs and also there was no significant difference in the mean cord serum TSH, T3 or T4 levels according to the fetus sex (P > 0.05). (2) The mean cord serum TSH level of fetus in vacuum extraction group was significantly higher than that of fetus in normal vaginal delivery or caesarean section group (P < 0.01). However, the mean TSH levels of neonates on day 3-5 in heel blood spotted filter paper were no significant differences among the three groups (P > 0.05). (3) The mixed cord blood TSH level related quite well to the TSH level obtained from heel blood on day 3-5, or cord venous serum samples (r = 0.67-0.84, P < 0.01). Our results suggest that measuring cord blood TSH level might be a feasible alternative method for neonatal congenital hypothyroidism screening.
本研究旨在探讨围产期因素及采样方法对胎儿垂体 - 甲状腺轴的影响。结果显示：（1）脐血促甲状腺激素（TSH）、三碘甲状腺原氨酸（T3）、甲状腺素（T4）与出生体重或产程之间均无线性关系（r = 0.03 - 0.12，P > 0.05）。使用宫缩剂分娩的胎儿脐血TSH、T3或T4的平均水平与未使用这些药物的胎儿相比无显著差异，且根据胎儿性别，脐血TSH、T3或T4的平均水平也无显著差异（P > 0.05）。（2）真空吸引组胎儿的脐血TSH平均水平显著高于正常阴道分娩组或剖宫产组胎儿（P < 0.01）。然而，三组足跟血斑滤纸法检测的新生儿出生后3 - 5天的TSH平均水平无显著差异（P > 0.05）。（3）混合脐血TSH水平与出生后3 - 5天足跟血或脐静脉血清样本中TSH水平相关性良好（r = 0.67 - 0.84，P < 0.01）。我们的结果表明，检测脐血TSH水平可能是新生儿先天性甲状腺功能减退症筛查的一种可行替代方法。
