新生儿暂时性甲状腺功能减退症：病因学研究。意大利暂时性甲状腺功能减退症协作研究。
Neonatal transient hypothyroidism: aetiological study. Italian Collaborative Study on Transient Hypothyroidism.
作者信息
Weber G, Vigone M C, Rapa A, Bona G, Chiumello G
机构信息
Department of Paediatrics, Scientific Institute H San Raffaele, University of Milan, Italy.
出版信息
Arch Dis Child Fetal Neonatal Ed. 1998 Jul;79(1):F70-2. doi: 10.1136/fn.79.1.f70.
AIMS
To define the aetiology of neonatal transient hypothyroidism (NTH) and recommend preventive measures.
METHODS
Maternal and perinatal clinical data on the use of antiseptics, drugs, and contrast agents containing iodine were collected from 40 subjects. Thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroxine (T4), thyroglobulin (TG), TSH receptor antibodies, thyroid peroxidase antibodies and urinary iodine were measured in random neonatal samples. In the mothers with known or suspected thyroid disorders, TSH, FT4, TSH receptor antibodies and thyroid peroxidase antibodies were also measured.
RESULTS
The NTH aetiology was identified in 85% of cases. More than 50% of the babies with transient hypothyroidism had been exposed to iodine; maternal transfer of antibodies had occurred in a third of them.
CONCLUSIONS
It is suggested that the practice of using iodine containing disinfectants should be withdrawn, and chlorhexidine substituted instead; that pregnant women should be advised of the adverse effects of using iodine products; and that thyroid function should be monitored whenever iodine is used.
目的
明确新生儿暂时性甲状腺功能减退症（NTH）的病因并推荐预防措施。
方法
收集40名受试者关于使用含碘防腐剂、药物和造影剂的母体及围产期临床数据。在随机抽取的新生儿样本中检测促甲状腺激素（TSH）、游离甲状腺素（FT4）、甲状腺素（T4）、甲状腺球蛋白（TG）、TSH受体抗体、甲状腺过氧化物酶抗体及尿碘。对于已知或疑似患有甲状腺疾病的母亲，也检测其TSH、FT4、TSH受体抗体及甲状腺过氧化物酶抗体。
结果
85%的病例明确了NTH的病因。超过50%的暂时性甲状腺功能减退症婴儿接触过碘；其中三分之一发生了母体抗体转移。
结论
建议停止使用含碘消毒剂的做法，改用氯己定替代；应告知孕妇使用碘产品的不良影响；并且每当使用碘时都应监测甲状腺功能。
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