早产儿暂时性低甲状腺素血症的临床表现及影响因素

Clinical characteristics and influencing factors of transient hypothyroxinemia in premature infants

目的了解早产儿暂时性低甲状腺素血症(THP)的发生情况。方法对早产儿筛查甲状腺素(T4)、促甲状腺素(TSH),计算THP的阳性率,分析临床表现及影响因素。结果早产儿THP总的阳性率30.8%(48/156),性别比较,差异无统计学意义(P>0.05);胎龄≤32周组阳性率55.0%,明显高于33～34周组(13.7%)及35～36周组(25.0%)。出生体重≤1 500 g组阳性率(81.8%)明显高于1 501～2 499 g组(22.0%)及≥2 500 g组(7.3%)。喂养困难、长磅不理想及红细胞增多症在THP组发生率高于正常组,经左旋甲状腺素片口服,3.0～8.0μg/(Kg.d),治疗后甲状腺功能多在3个月内恢复正常。结论早产儿THP发生率与胎龄和出生体重有关,THP患儿临床表现以喂养困难及长磅不理想多见,经治疗后甲状腺功能多在3个月内恢复。

Objective To investigate the incidence of transient hypothyroxinemia （THP） in premature infants and its associated factors. Methods Thyroxin （T4 ） and Thyroid Stimulating Hormone （TSH） were measured in premature infants. The incidence of THP was calculated and clinical characteristics of THP and influencing factors were analyzed. Results The total incidence of THP was 30. 8 %. There was no statistical difference between male and female infants. The incidence of THP was significantly higher among the infants whose gestational age was less than 32 weeks （ 55.0 % ） than those whose gestational age was 33 - 34 weeks or 35 - 36 weeks. The incidence of THP was significantly higher among infants whose birth weight was less than 1 500 g （81.8 % ） compared with those whose birth weight was 1 501 - 2 499 g or greater than or equal to 2 500 g. Anorexia, no body weight increase and polycytbemia were more frequent in THP group than that of normal group. The thyroid function of most infants recovered within the three months after therapy of oral levothyroxine （3.0 - 8.0 μg/Kg · d）. Conclusion The incidence of THP was related to gestational age and birth weight, and not related to gender. Most THP patients showed feeding obstacles and no body weight increase. The recovery period of thyroid function was generally less than three months after therapy.