分娩因素及采血方法对新生儿脐血促甲状腺激素及甲状腺激素水平的影响  

Influence of perinatal factors and samplingmethods on thyroid stimulating hormone andthyroid hor'none levels in cord blood

作　　者：时立新[1] 马启玲[1] 张家秀[1] 徐淑静[1] 方颖[1] 庄惠君[1] 时钟孚[1] 于世光[1] 曾金玲[1] 

机构地区：[1]贵阳医学院附属医院内分泌科,贵阳医学院附属医院内科,贵阳医学院附属医院妇产科

出　　处：《中华妇产科杂志》1994年第12期714-716,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：通过对不同分娩及采血方法下新生儿血甲状腺激素等的测定，了解这些因素对新生儿血促甲状腺激素（ＴＳＨ）和甲状腺激素水平的影响。结果如下：（１）新生儿脐静脉血清ＴＳＨ、三碘甲状腺氨酸（Ｔ＿３）和甲状腺素（Ｔ＿４）水平与出生体重及宫缩时间无显著性相关（ｒ＝０．０３～０．１２，Ｐ＞０．０５），新生儿脐静脉血清ＴＳＨ、Ｔ＿３和Ｔ＿４水平不受性别及是否用宫缩剂的影响（Ｐ＞０．０５）；（２）胎头吸引器助产分娩新生儿脐静脉血纸片ＴＳＨ水平明显高于正常分娩及剖宫产组（Ｐ＜０．０１），三组新生儿足跟血纸片ＴＳＨ水平的差异无显著性（Ｐ＞０．０５）；（３）新生儿脐混合血纸片ＴＳＨ水平与脐静脉血清、脐静脉血纸片及新生儿出生后３～５天足跟血纸片ＴＳＨ水平呈显著正相关（ｒ＝０．６７～０．８４，Ｐ＜０．０１）。测定脐血纸片ＴＳＨ水平不失为一种简便可靠的先天性甲状腺功能低减的筛查方法。he present study was designed to explore the in-fluence of perinatal factors and sampling methods on fe-tal pituitary-thyroid axis. The results showed: (1)There was no hnear relation between cord serum thyroidstimulating hormone (TSH), triiodothyronine (T_3),thyroxine(T_4) and either birth weight or the duration oflabor (r= 0. 03～0. 12, P> 0. 05). The mean cordserum TSH , T_3 or T_4 levels in the fetus delivered withuterotonic agents were no significant difference fromthose in fetus without these drugs and also there was nosignificant difference in the mean cord serum TSH, T_3or T_4 levels according to the fetus sex (P> 0. 05 ). (2)The mean cord serum TSH level of fetus in vacuum ex-traction group was significantly higher than that of fetusin normal vaginal delivery or caesarean section group (P<0. 01). However, the mean TSH levels of neonateson day 3￣5 in heel blood spotted filter paper were nosignificant differences among the three groups (P >0. 05). (3) The mixed cord blcod TSH level relatedquite well to the TSH level obtained from heel blood onday 3￣ 5 , or cord venous serum samples (r= 0. 67￣ 0.84, P<0.01 ). Our results suggest that measuring cordblood TSH level might be a feasible alternative methodfor neonatal congenital hypothyroidism screening.

关 键 词：促甲状腺激素 分娩 脐血 甲状腺激素 新生儿 

分 类 号：R722.103[医药卫生—儿科] R714.54[医药卫生—临床医学]