早产儿甲状腺激素浓度变化与疾病危重程度相关性的研究

Study on the correlation between serum thyroid hormone level and severity of disease in preterm infants

目的研究早产儿血清甲状腺激素浓度变化与疾病危重程度的相关性,为早期筛查危重早产儿提供依据。方法选取江西省儿童医院2018年3月-2019年6月收取的209名早产儿为研究对象,按疾病危重程度分为危重组(n=23)、危重转归组(n=60)、非危重组(n=126)。抽取早产儿出生后第7、14天静脉血检测FT3、FT4、TSH的浓度,计算第7、14天甲状腺激素的浓度差值△FT3、△FT4、△TSH,分析FT3、FT4、TSH、△FT3、△FT4、△TSH与疾病之间的关系。结果危重组、危重转归组和非危重组早产儿出生胎龄、体重、性别比较差异无统计学意义(P>0.05)。危重组和危重转归组第14天FT3、FT4的浓度均较第7天高,但危重组早产儿第7、14天FT3的浓度均低于危重转归组和非危重组,差异有统计学意义(P<0.05);危重组的△FT3低于危重转归组和非危重组,非危重组的△FT4明显低于其他两组,差异有统计学意义(F=3.727、11.860,P<0.05);三组间△TSH差异无统计学意义(F=1.082,P>0.05)。结论FT3浓度与疾病危重程度密切相关,疾病越严重,FT3浓度越低。

Objective To analyze the correlation between serum thyroid hormone level and disease severity of preterm infants,so as to provide reference for early screening of critically ill infants.Methods A total of 209 preterm infants in Children's Hospital of Jiangxi Province from March 2018 to June 2019 were selected as study objects,and were divided into critically-ill group(n=23),recovery group(n=60)and non-critical group(n=126)according to the severity of disease.Serum levels of FT3,FT4 and TSH on the 7th and 14th day after birth were tested,and the difference of thyroid hormone concentrations on the 7th and 14th day(△FT3、△FT4、△TSH)was calculated.The association of disease with FT3,FT4,TSH,△FT3,△FT4 and△TSH was analyzed.Results There were no differences in gestational age,weight and gender among the three groups of premature infants(P>0.05).The concentrations of FT3 and FT4 in the critically ill group and recovery group on the 14th day after birth were higher than those on the 7th day after birth,but the concentrations of FT3 in the critically ill premature infants on the 7th day and 14th day were lower than those in the recovery group and non-critically ill group(P<0.05).△FT3 of the critically-ill group was lower than that of the recovery group and the non-critical group,△FT4 of the non-critical group was significantly lower than that of the other two groups(F=3.727,11.860,P<0.05).And△TSH was not significantly different among the three groups(F=1.082,P>0.05).Conclusions The concentration of FT3 is closely related to the severity of the disease.And the more severe the disease,the lower the concentration of FT3.