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

王巧芳, 晏长红, 罗丁珍, 陈丽萍, 杨利

中国儿童保健杂志 ›› 2021, Vol. 29 ›› Issue (3) : 238-242.

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中国儿童保健杂志 ›› 2021, Vol. 29 ›› Issue (3) : 238-242. DOI: 10.11852/zgetbjzz2020-0661
科研论著

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

  • 王巧芳1, 晏长红1, 罗丁珍1, 陈丽萍1, 杨利2
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Study on the correlation between serum thyroid hormone level and severity of disease in preterm infants

  • WANG Qiao-fang*, YAN Chang-hong, LUO Ding-zhen, CHEN Li-ping, YANG Li
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摘要

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。

Abstract

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.

关键词

早产儿 / 甲状腺激素 / 危重症 / 相关性

Key words

preterm infant / thyroid hormone / critically ill / correlation

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导出引用
王巧芳, 晏长红, 罗丁珍, 陈丽萍, 杨利. 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[J]. 中国儿童保健杂志. 2021, 29(3): 238-242 https://doi.org/10.11852/zgetbjzz2020-0661
WANG Qiao-fang, YAN Chang-hong, LUO Ding-zhen, CHEN Li-ping, YANG Li. Study on the correlation between serum thyroid hormone level and severity of disease in preterm infants[J]. Chinese Journal of Child Health Care. 2021, 29(3): 238-242 https://doi.org/10.11852/zgetbjzz2020-0661
中图分类号: R722.6   

参考文献

[1] Willianms FLR,Simpson J,Delahunty C,et al.With collaboration from the Scottish Preterm Thyroid Group 2004 Developmental trends in cord and postpartum serum thyroid hormones in preterm infants[J].J Clin Endocrinol Metab,2004,89:5314-5320.
[2] Fisher DA.Thyroid system immaturities in very low birth weight premature infants[J].Semin Perinatol,2008,32:387-397.
[3] Chapman AK,Farmer AJ,Mastrandrea LD.Neonatal thyroid function and disorders[J].Clin Obstet Gynecol,2019,62(2):373-387.
[4] Müller J,Heuer H.Understanding the hypothalamus-pituiary-thyroid axis in mct8 deficiency[J].Eur Thyroid J,2012,1(2):72-79.
[5] Farwell AP.Nonthyroidal illnesss syndrome[J].Curr Opin Endocrinol Diabetes Obes,2013,20:478-484.
[6] 何 柳,夏 斌,虎春元.新生儿危重病例评分法的临床应用[J].中华妇幼临床医学杂志(电子版),2017,13(2):162-168.
[7] Bello G,Pennisi MA,Montini L,et al.Nonthyroidal illess syndrome and prolonged mechanical ventilation in patients admitted to the ICU[J].Chest,2009,135:1448-1454.
[8] Gangemi EN,Garino F,Berchialla P,et al,Low triiodothyronine serum levels as a predictor of poor prognosis in burn patients[J].Burns, 2008,34:817-824.
[9] 荣丽英.新生儿正常甲状腺病态综合征[J].医学综述,2006,12(6):366-368.
[10] Chatzitomaris A,Hoermann RE, Midgley J,et al.Thyroid allostasis-adaptive responses of thyrotropic feedback control to conditions of strain,stresss,and developmental programming[J].Front Endocrinol,2017,8(163):1-28.
[11] 邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].5版.北京:人民卫生出版社,2019:923.
[12] Sperling MA.Pediatric endocrinology[M].4th ed. Philadelphia:Elsevier, 2014:200.
[13] Van den Berghe G.Non-thyroidal illness in the ICU:a syndrome with different faces[J].Thyroid,2014,24(10):1456-1465.
[14] Gomella TL,Cunningham MD,Eyal FG.Neonatology[M],7th ed.New York, McGraw-Hill Education,2013:913.
[15] Michalaki M,Vagenakis AG,Makri M,et al.Dissociation of the early decline in serum T3 concentration and serum IL-6 rise and TNF-alpha in nonthyroidal illness syndrome induced by abdominal surgery[J].J Clin Endocrinol Metab,2001,86:4198-4205.
[16] Ray DC,Macduff A,Drummond GB,et al.Endocrine measurements in survivors and non-survivors from critical illness[J].Intersive Care Med,2002,28:1301-1308.
[17] Luo B,Yu Z,Li YP.Thyroid hormone disorders and sepsis[J].Bio-Med Mater Eng,2017,28(Suppl):237-241.
[18] Eng L,Lam L.Thyroid function during the fetal and neonatal periods[J].Neoreviews,2020,21(1):e30-e36.
[19] Langouche L,Vander Perre S,Marques M,et al.Impact of early nutrient restriction during critical illness on the nonthyroidal illness syndrome and its relation with outcome:a randomized,controlled clinical study[J].J Clin Endocrinol Metab,2013,98:1006-1013.
[20] Mebis L, Eerdekens A, Güiza F, et al.Contribution of nutritional deficit to the pathogensis of the nonthyroidal illnesss syndrome in critical illnesss:a rabbit model study[J].Endocrinology,2012(153):973-984.
[21] Morgan J,Young L,McGuire W.Delayed introduction of progressive enteral feeds to prevent necrotising enterocolitis in very low birth weight infants[J].Cochrane Database Syst Rev, 2014,12:CD001970.
[22] Dutta S,Singh B,Chessell L,et al.Guidelines for feeding very low birth weight infants[J].Nutrients,2015,7:423-442.
[23] Sweet DG,Garnielli V,Greisen G,et al.European consensus guidelines on the management of respiratory distress syndrome[J].Neonatology,2017,111:107-125.
[24] 中华医学会肠外肠内营养学分会儿科学组,中华医学会儿科学分会新生儿学组,中华医学会小儿外科学分会新生儿外科学组.中国新生儿营养支持临床应用指南[J].中华小儿外科杂志,2013,34(10):782-787.
[25] Weekers F,Giulietti AP,Michalaki M,et al.Endocrine and metabolic effects of growth hormone compared with GH-releraingpeptide,thyrotropin-releasing hormone,and insulin infuseon in a rabbit model of prolonged critical illness[J].Endocrinology,2004,145:205-213.

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江西省卫生健康委科技项目(20165501)

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