窒息新生儿甲状腺功能异常临床分析

Clinical analysis of abnormal thyroid function of asphyxial neonate

目的 探讨窒息对新生儿甲状腺功能的影响及其与临床的关系。方法 采用磁性微粒分离的免疫酶联法 (IEMA) ,测定 4 5例窒息新生儿三碘甲腺原氨酸 (T3 )、甲状腺素 (T4)及促甲状腺激素 (TSH)水平 ,并与 32例正常儿进行对照。结果 窒息新生儿T3 ,T4值明显低于正常对照组 (P <0 .0 1) ,重度窒息儿T3 ,T4值明显低于轻度窒息儿 ,产前窒息较产时、产后窒息儿甲状腺素抑制更为明显 ,窒息组TSH值与正常组比较无显著性差异 (P >0 .0 5 )。窒息儿的甲状腺功能异常随着原发病的好转逐渐恢复。结论 窒息新生儿可出现暂时性低甲状腺血症 ,但只需对原发病治疗 ,勿需补充甲状腺素。

Objective It is to study the effect of asphyxia on thyroid function of neonate and the relation with clinic.Methods The levels of triiodothyronine (T 3), thyroxine (T 4) and thyroid-stimulating hormone(TSH) of 45 asphyxial neonates and 32 healthy neonates were determined with Immuno-enzymo metric assay(IEMA) separated by magnetic particle.Results The levels of T 3, T 4 of asphyxial neonates were obviously lower than that in healthy group ( P <0.01). The levels of T 3, T 4 of hard asphyxial neonates were obviously lower than that of light ones. The secretion inhibition of thyroid hormone was more obvious in the neonate who had been asphyxiated before birth than that during and after birth. There was no significant difference in the levels of TST between asphyxial group and normal group ( P >0.05). The abnormality of thyroid function would recover gradually when the primary disease improved.Conclusion Temporary hypothyroxinemia may appear in the asphyxial neonate. It was not necessary to supply thyroid hormone but only to treat the primary disease.