30例低三碘甲状腺原氨酸综合征临床观察

Clinical research of 30 premature infants with lowhypotriiodothyronine syndrome

目的观察低三碘甲状腺原氨酸(T3)综合征对早产儿的影响。方法按照纳入标准及排除标准选取2019年1—12月蚌埠医学院第一附属医院新生儿病房住院的早产儿作为研究对象,在生后4~7 d及第4周采集空腹静脉血2 mL,应用电化学发光法测定血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)及三碘甲状腺原氨酸(T3)水平。依据诊断标准将诊断为低T3的30例早产儿作为观察组,同胎龄甲状腺功能正常的30例早产儿作为对照组,2组患儿性别、胎龄等一般资料比较差异无统计学意义(均P>0.05),均给予相同的基础支持治疗。观察2组早产儿在黄疸持续时间、喂养不耐受、住院天数、恢复出生体重天数、纠正胎龄40周时NBNA评分方面的差异。结果 2组早产儿生后4~7 d的T3值(t=-19.042,P<0.001)、FT3值(t=-22.041,P<0.001)比较差异有统计学意义,生后4周的T3值(t=-1.933,P=0.059)及FT3值(t=-1.622,P=0.110)比较差异无统计学意义。2组早产儿黄疸持续时间(t=2.759,P=0.008)、喂养不耐受(χ~2=8.531,P=0.003)、住院天数(t=6.471,P<0.001)、恢复出生体重天数(t=6.584,P<0.001)比较差异有统计学意义,2组早产儿纠正胎龄40周NBNA评分比较差异无统计学意义(t=-1.842,P=0.071)。结论低T3综合征患儿较正常甲状腺功能患儿的黄疸持续时间、住院天数及恢复出生体重时间延长,喂养不耐受发生率高,但短期神经发育无明显差异。

Objective To observe the adverse effects of low hypotriiodothyronine(T3)syndrome on premature infants.Methods Thirty premature infants hospitalised in the neonatal ward of The First Affiliated Hospital of Bengbu Medical College from January to 2019 to December 2019 were selected.About 4 to 7 days and 4 weeks after birth,2 mL of fasting venous blood was collected from the infants.Serum thyroid-stimulating hormone(TSH),free triiodothyronine(FT3)and triiodothyronine(T3)were determined via electrochemiluminescence.According to the diagnostic criteria,premature infants diagnosed with low T3 were taken as the observation group(n=30),whereas premature infants with normal thyroid functions at the same gestational age were taken as the control group(n=30).No statistical difference was observed in the general conditions of the two groups(P>0.05),both group were given with the same basic supportive treatment.Differences in the duration of jaundice,feeding intolerance,hospitalisation days,days of birth weight recovery and neonatal behavior neurological assessment(NBNA)test scores at 40 weeks of gestational age were observed between the two groups.Results Between the two groups,T3 levels at 4 to 7 days after birth(t=-19.042,P<0.001)and FT3 levels at 4 weeks after birth(t=-22.041,P<0.001)were statistically significant.At 4 weeks after birth,T3 levels(t=-1.933,P=0.059)and FT3 levels(t=-1.622,P=0.110)were not statistically significant.The differences in jaundice duration(t=2.759,P=0.008),feeding intolerance(χ~2=8.531,P=0.003),hospitalisation days(t=6.471,P<0.001)and birth weight recovery days(t=6.584,P<0.001)were statistically significant between the two groups.However,no statistically significant difference(t=-1.842,P=0.071)was observed in NBNA scores between the two groups at the correct gestational age of 40 weeks.Conclusion Children with a low T3 syndrome have longer jaundice durations,hospitalisation days and weight recovery times,as well as a higher incidence of feeding intolerance,than children with normal thyroid functions.Nevertheless,their short-term neurodevelopment was not significantly influenced.