新生儿高胆红素血症甲状腺功能改变及意义

The observation and significance of thyroid function in neonatal hyperbilirubinemia

目的探讨新生儿高胆红素血症(简称高胆)对甲状腺功能的影响。方法对162例高胆新生儿采用竞争性放射免疫法进行血清甲状腺功能即三碘甲腺原氨酸(triiodothyronine,T3)、甲状腺素(thyroxine,T4)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(thyroid-stimulating hormone,TSH)测定,对照组参照文献结果。按黄疸程度分为轻度、中度、重度三组比较。结果轻、中度高胆组T4、FT3低于对照组(P<0.01),T3、FT4、TSH与对照组比较差异无显著性(P>0.05);重度组FT3、FT4、TSH低于对照组(P<0.05～0.01),T3、T4与对照组比较差异无统计学意义(P均>0.05)。高胆新生儿甲状腺功能T3、T4、FT3、FT4、TSH与TSB水平无明显相关性(P均>0.05)。结论新生儿高胆可引起甲状腺功能降低,T4和FT3降低可能是高胆新生儿甲状腺损害的敏感指标,FT4降低对预警病情严重有意义。

Objective： To investigate how the neonatal hyperbilirubinemia affects the thyroid function. Methods： The thyroid func- tion of blood serum in 162 neonates with hyperbilirubinemia was tested by competitive radioimmunoassay. The concentrations of triiodo- thyronine （T3）, thyroxine （T4）, FT3, FT4, thyroid- stimulating hormone （TSH） were tested, and the control group consulted the literature results. The neonates were divided into three groups as the light degree, the moderate degree and the severe degree according to the degree of jaundice. Results ： The concentrations of T4 and FT3 in the light degree and the moderate degree group were lower than the control group （ P 〈 0. 01 ）. There was no statistical significance when comparing the concentrations of the T3, FT4, and TSH in the light degree and the moderate degree group with the control group （ P 〉 0. 05）. The concentrations of the FT3, FT4, and TSH in the severe group were lower than the control group （P 〈 0. 05 - 0.01 ）. There was no statistical significance when comparing the concen- trations of the T3, and T4 in the severe degree group with the control group （ P 〉 0. 05 ）. And there was no evident correlation between the T3, T4, FT3, FT4 and TSH in the neonates with hyperbilirubinemia and the level of TSB （ P 〉 0. 05 ）. Conclusion ： The neonatal hyperbilirubinemia may cause the decrease of the thyroid function. The decrease of the concentrations of T4 and FT3 may be the sensi- tive indicators of thyroid damage in the neonates with hyperbilirubinemia, while the decrease of FT4 is meaningful to warn the patients＇ condition.