PVH-IVH合并PVL的早产儿甲状腺激素水平变化

Changes of thyroid hormone levels in premature infants with PV-IVH combined with PVL

目的探讨脑室周-脑室内出血(PVH-IVH)合并脑白质软化(PVL)的早产儿甲状腺激素水平的变化。方法选取2015年8月至2016年12月入住该院早产儿病区及新生儿重症病房的胎龄32~34周的适于胎龄儿92例作为研究对象。出生后4周依据头颅磁共振成像(MRI)结果是否合并PVL将其分为PVL组和非PVL组。所有研究对象分别于出生后1、4周清晨9:00采集外周血,采用化学发光法测定血清游离三碘甲腺原氨酸(FT3)、血清游离甲状腺素(FT4)、促甲状腺激素(TSH)值,对比分析不同组治疗前后及组间FT3、FT4、TSH的水平变化。结果 PVL组4周时FT3、FT4水平均较非PVL组低,差异均有统计学意义(P<0.05),TSH水平高于非PVL组,差异有统计学意义(P<0.05),PVL组出生后1周时FT3、FT4水平均低于非PVL组,差异均有统计学意义(P<0.05),TSH水平高于非PVL组,差异有统计学意义(P<0.05)。结论早产儿PVH-IVH是否好转及是否合并PVL与低甲状腺功能水平相关,提示动态检测PVH-IVH早产儿甲状腺激素水平对判断和评估预后有一定的临床意义。

Objective to investigate the changes of thyroid hormone levels in premature infants with intraventricular hemorrhage(PVIVH)and cerebral white matter softening(PVL).Methods A total of 92 cases of gestational age 3234 weeks from August 2015 to December 2016 in the preterm infant ward and neonatal intensive care unit were selected as the subjects.4 weeks after birth,according to the results of head magnetic resonance imaging(MRI),whether PVL was merged,it was divided into PVL group and non PVL group.All the subjects collected peripheral blood at 9:00 in the morning of 1,2 and 4 weeks after birth.The serum serum free three iodide(FT3),serum free thyroxine(FT4)and thyroid stimulating hormone(TSH)were measured by chemiluminescence,and the levels of FT3,FT4 and TSH were analyzed in different groups before and after treatment.Results The level of FT3 and FT4 in group PV was lower than that of non PVL group at 4 weeks.The difference was statistically significant(P<0.05),and the level of TSH was higher than that of non PVL group.The difference was statistically significant(P<0.05).The thyroid FT3 and FT4 levels were lower than those in the non PVL group at the 1 week of birth,and the difference was statistically significant(P<0.05).The difference was higher than that of non PVL group.There were statistical significance(P<0.05).Conclusion The improvement of PIVH in preterm infants and whether or not the combination of PVL is associated with low thyroid function,suggesting that the dynamic detection of PIVH thyroid hormone levels in premature infants is of certain clinical significance in judging and evaluating the prognosis.T.