早产儿暂时性低甲状腺素血症

Transient hypothyroxinemia in preterm infant

随着新生儿重症监护救治技术的进展,极低出生体质量早产儿存活率明显提高。由于这些早产儿各器官系统结构和生理功能未成熟,新生儿期发病率高,而疾病可进一步影响早产儿的神经发育。甲状腺素在脑发育中具有重要作用,而在早产儿脑发育关键期如发生甲状腺功能紊乱则可对其脑发育产生深远影响。暂时性低甲状腺素血症(THOP)是早产儿最常见的甲状腺功能障碍,与极低出生体质量早产儿不良神经发育结局有关,补充甲状腺素可改善极低出生体质量早产儿发生THOP后的神经发育预后。但目前对早产儿正常神经发育所需的适宜的血清甲状腺素水平尚未明确,因而需要更进一步的随机对照研究为临床提供可靠的证据。

With the advances in the care of premature infants in neonatal intensive care unit（NICU）,the survival of very low birth weight premature infants increased significantly.These infants are characterized by a variety of organ and physiological systems immaturities predisposing to a high prevalence of neonatal morbidities.These morbidities have a major impact on neurodevelopment.Thyroid hormones are required for normal development of the human brain.Derangements of critical thyroid function during the sensitive window in prematurity when early development occurs may have a range of long-term effects on brain development.Transient hypothyroxinemia of prematurity（THOP） is the most common thyroid dysfunction in premature infants.Several studies have demonstrated a correlation of THOP with poor neurodevelopment outcome in very low birth weight premature infants.There is suggestive evidence that thyroid hormone supplementation in very low birth weight infants with THOP can improve mental outcome.However,appropriate serum levels of thyroid hormones to achieve optimal brain maturation have not been quantified.Further prospective placebo controlled randomized clinical trial will provide sufficient evidence for clinical practice.