不同分娩方式新生儿脐血甲状腺激素水平的探讨

Study on cord blood thyroid hormone levels of neonate in different delivery way

目的：探讨阴道自然分娩与剖宫产分娩两种分娩方式的新生儿出生时甲状腺激素水平。方法：收集2010年4-12月在我院分娩的足月新生儿251例，其中，阴道分娩组100例，剖宫产组151例，分娩后立即抽取新生儿脐血2ml，应用化学发光免疫分析仪检测脐血中游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）及促甲状腺激素（TSH）的含量。结果：两组新生儿脐血FT3、FT4值比较，差异无统计学意义（P〉0．05）；两组新生儿脐血TSH值比较。差异有高度统计学意义（P〈0．05）。新生儿体重与TSH、喁、甩水平相关系数（r）分别为：0．0061、0．2228、0．1151，无显著相关性（均P〉0．05）。不同性别新生儿脐血甲状腺激素FT3、FT4及TSH水平比较。差异无统计学意义（P〉0．05）。结论：新生儿脐血甲状腺激素水平不受新生儿出生体重及性别的影响，两种不同的分娩方式对新生儿TSH造成不同影响，FT3、FT4不受影响。加强对胎儿期甲状腺功能的检测具有重要意义。

Objective： To investigate cord blood thyroid hormone levels of neonate borned in vagina and cesarean section way. Methods： 251 cases umbilical cord bloods were collected from the neonate born in our hospital from April to December 2010, among which 100 cases were vaginal delivery group and 151 cases were cesarean section group. The degree of free friiodothyronine （FT3）, free thyroxine （TF4）, and thyroid stimulating hormone （TSH） in 2 ml neonatal cord blood were detected by chemiluminescence immunoassay analyzer. Results： There was no significant difference of the FT3 and FT4 degree between the two groups （P〉0.05）. The degree of TSH was higher in vaginal delivery group than that of cesarean section group, and there was a significant difference （P〈0.05）. The correlation coefficients of neonatal weight and degree of TSH, FT3 and FT4 were 0.006 1, 0.222 8 and 0.115 1 respectively, and there was no significant correlation （all P〉0.05）. The degree of FT3, FT4 and TSH was not obviously correlated in different genders （P〉0.05）. Conclusion： The newborn thyroid hormone level is not affected by weight or gender. Delivery way affects the degree of TSH in neonatal cord blood, but has no effect on FT3 or FT, Detection for thyroid hormone levels in fetus period will play an important role.