健康和患病新生儿的甲状腺功能

Department of Pediatrics, Chung Shan Medical and Dental College Hospital, Taichung, Taiwan, R.O.C.

Zhonghua Yi Xue Za Zhi (Taipei). 1994 Jul;54(1):51-6.

BACKGROUND

Low serum thyroid hormone concentrations are frequently observed in critically ill patients. Low-birth-weight preterm infants have also been reported to contain lower serum thyroxine (T4) levels when compared with normal term infants. Investigating the differences of the thyroid function between sick and healthy term and preterm infants becomes a worthwhile task.

METHODS

Thyroid functions were measured in 80 newborn infants (including 31 critically ill neonates admitted to neonatal intensive care unit and 49 healthy controlled neonates). The neonates were divided into three groups in terms of gestational age. Group 1 consisted of 10 sick and 12 healthy term neonates with a gestational age > or = 38 weeks. Group 2 consisted of 9 sick and 26 healthy preterm infants with gestational ages ranging between 32 and 36 weeks. Group 3 consisted of 12 sick and 11 healthy very low birth weight (VLBW) infants with a gestational age < or = 31 weeks. Serum thyroxine (T4), thyroid stimulating hormone (TSH), free T4, and triiodothyronine (T3) concentrations were measured at 1 and 5 days after birth.

RESULTS

Observed data indicated that sick neonates in three groups had significantly lower T4 values (p = 0.05) than healthy term and preterm neonates. TSH levels of sick neonates in three groups were not significantly different (p > 0.05) from those of healthy neonates on day 1 and day 5. Serum free T4 levels were significantly lower (p < 0.05) in sick than in healthy premature infants. Sick VLBW premature infants had significantly lower T3 values (p < 0.05) than healthy VLBW premature infants on day 1 and day 5.

CONCLUSIONS

Low serum T4, free T4, T3 concentrations are commonly found in sick neonates, whereas serum TSH values are not significantly different between sick and healthy neonates.

背景

危重症患者中经常观察到血清甲状腺激素浓度较低。据报道，与正常足月儿相比，低出生体重早产儿的血清甲状腺素（T4）水平也较低。研究患病和健康的足月儿及早产儿之间甲状腺功能的差异成为一项有价值的任务。

方法

对80例新生儿（包括31例入住新生儿重症监护病房的危重症新生儿和49例健康对照新生儿）进行甲状腺功能检测。根据胎龄将新生儿分为三组。第1组由10例患病和12例健康的足月儿组成，胎龄≥38周。第2组由9例患病和26例健康的早产儿组成，胎龄在32至36周之间。第3组由12例患病和11例健康的极低出生体重（VLBW）婴儿组成，胎龄≤31周。在出生后1天和5天测量血清甲状腺素（T4）、促甲状腺激素（TSH）、游离T4和三碘甲状腺原氨酸（T3）浓度。

结果

观察数据表明，三组患病新生儿的T4值（p = 0.05）显著低于健康的足月儿和早产儿。三组患病新生儿的TSH水平在第1天和第5天与健康新生儿相比无显著差异（p>0.05）。患病早产儿的血清游离T4水平显著低于健康早产儿（p < 0.05）。患病的极低出生体重早产儿在第1天和第5天的T3值显著低于健康的极低出生体重早产儿（p < 0.05）。