低出生体重儿并甲状腺功能低下的近期随访

Short-term follow-up study on the low birth weight infants with hypothyroidism

目的 :探讨低出生体重儿 (LBWI)甲状腺功能 (甲功 )变化与生长发育的关系。方法 :对日龄大于 5天LBWI 145例 ,正常新生儿 6 2例行甲功检测 ;并对上述LBWI甲功低下 96例及甲功正常 49例进行随访至 15～ 30个月 (纠正年龄 ) ;测量身体生长值及采用贝利婴幼儿发育量表行智力发育指数 (MDI)及运动发育指数 (PDI)的测定。结果 :LBWI发生甲功低下与胎龄、出生体重及病危程度密切相关 (P <0 0 5 ) ;甲功低下组及甲功正常组在身高、体重、头围生长落后发生率有差异 (P <0 0 5 ) ,在MDI、PDI发育值及MDI、PDI低下发生率有明显差异 (P <0 0 5或 <0 0 1)。结论 :胎龄小、体重轻、病情危重可致暂时性低甲状腺激素血症 ;而暂时性低甲状腺激素血症是影响LBWI预后的重要因素之一。

Objective:To explore the relation of the changes of thyroid function to growth and development in the low birth weight infants(LBWI).Methods:Tests of thyroid function were performed in 145 LBWI and 62 normal neonates aged more than 5 days.In LBWI,96 with hypothyroidism and 49 with euthyroidism were followed up continuously till they were 15 to 30 months old (corrected age).The mental development index(MDI)and the psychomtor development index(PDI)were determined by making use of Bayleys scales of infant development.The body growth values were measured at the same time.Results:Hypothyroidism in LBWI was closely correlated with fetal age.birth weight and the severity of illness(P<0 05).There was difference in the incidences of undergrown body height,weight and head circumference between the hypothyroidism group and the euthyroidism group(p<0 05).As for the MDI and PDI values as well as the incidences of low MDI and PDI,the difference between the two groups was significant(P<0 05 or P<0 01).Conclusion:young fetal age,low body weight and severe disease may cause transient hypothyroxinemia,which is one of the improtant factors affecting the prognosis of LBWI.