左旋甲状腺素钠治疗危重早产儿低T_3综合征的分析

Clinical efficacy of sodium levothyroxine on treatment of critically ill premature infants with low T_3 syndrome

目的探讨危重早产儿低三碘甲状腺原氨酸(T_3)综合征早期使用左旋甲状腺激素治疗的临床疗效。方法将2011年7月至2013年7月在西安交通大学附属3201医院就诊的64例危重低T_3综合征早产儿随机分为治疗组和对照组,在常规治疗的基础上,治疗组给予甲状腺素片治疗,观察两组临床特点和T_3、游离三碘甲状腺原氨酸(FT_3)水平的变化。结果两组患儿T_3和FT_3水平都随着原发疾病的好转及日龄的增长逐渐恢复,治疗组增长更明显,治疗2周时两组间T_3、FT_3比较有显著差异(t值分别为3.25、4.81,均P<0.05),治疗开始和治疗4周时两组比较无显著性差异(t=0.19~1.95,均P>0.05)。两组患儿体重恢复时间、静脉营养时间、黄疸持续时间、住院天数进行比较,均有显著性差异(t=5.012~8.960,均P<0.05)。结论低T_3综合征的危重早产儿早期给予甲状腺素片治疗,可缩短住院日,有利于疾病恢复。

Objective To explore the clinical efficacy of early treatment of low triiodothyronine（T_3）syndrome with levothyroidin in critically ill preterm infants.Methods Sixty-four critically ill preterm infants with low T_3 syndrome visiting 3201 Affiliated Hospital of Xi＇an Jiaotong University from July 2011 to July 2013 were randomly divided into treatment group and control group.Treatment group was given thyroxine replacement therapy on basis of conventional treatment.Changes of clinical manifestations,T_3 and free triiodothyronine（FT_3）levels were observed in two groups.Results Levels of T_3 and FT_3 in both groups recovered gradually with improvement of primary disease and increase of age,and the growth in treatment group was more obvious.There were significant differences in T_3 and FT_3 between two groups after treatment for 2 weeks（t value was 3.25 and 4.81,respectively,both P〈0.05）,but there were no significant differences between two groups before and at 4 weeks after treatment（t value ranged 0.19-1.95,both P〈0.05）.Differences in body weight recovery time,parenteral nutrition time,duration of jaundice and hospitalization days were significant in two groups（t value ranged 5.012-8.960,all P〈0.05）.Conclusion Thyroxine therapy used in early treatment of critically ill preterm children with low T_3 syndrome can shorten hospital stay,and it is conducive to recovery of disease.