分娩方式对新生儿脐血甲状腺功能影响的研究  

A study on influences of delivery patterns on TSH,T_3 and T_4 in newborn cord blood

作　　者：李忠祥[1] 卢莉萍[1] 戴淑玲[1] 冷海娜[1] 侯明滨[1] 于恩燕[1] 

机构地区：[1]山东省潍坊市妇幼保健院,山东潍坊261011

出　　处：《中国妇幼健康研究》2008年第1期7-9,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的了解分娩方式对新生儿脐血甲状腺功能的影响。方法随机选择2006年1月至12月在山东省潍坊市妇幼保健院住院分娩、无妊娠合并症及并发症的产妇120例为研究对象,按分娩方式分为平产分娩组、胎头吸引助产组和择期剖宫产组,于分娩断脐后采集脐动脉血测定甲状腺功能。结果促甲状腺激素水平平产组为14.50±1.87μIU/mL、胎吸组为13.97±1.68μIU/mL,两组之间无差异(t=1.333,P>0.05);剖宫产组为7.47±2.12μIU/mL,与前两组比较均有极显著性差异(t值分别为15.728、15.197,P<0.001)。三碘甲状腺原氨酸水平平产组为0.88±0.24nmol/L,胎吸组为0.84±0.21nmol/L,两组之间无差异(t=0.793,P>0.05);剖宫产组为0.76±0.16nmol/L,与前两组比较均有显著性差异(t值分别为2.631、1.916,P<0.05)。游离三碘甲状腺原氨酸水平平产组为2.85±0.56pmol/L,胎吸组为2.83±0.52pmol/L,两组之间无差异(t=0.166,P>0.05);剖宫产组为2.64±0.46pmol/L,与前两组比较均有显著性差异(t值分别为1.833、1.731,P<0.05)。甲状腺素水平平产组为157.12±34.67nmol/L,胎吸组为152.74±32.15nmol/L,两组之间无差异(t=0.318,P>0.05);剖宫产组为139.64±40.32nmol/L,与前两组比较均有显著性差异(t值分别为2.079、1.852,P<0.05)。游离甲状腺素水平平产组为22.18±4.64pmol/L,胎吸组为20.64±3.88pmol/L,两组之间无差异(t=1.610,P>0.05);剖宫产组为16.80±4.06pmol/L,与前两组比较均有极显著性差异(t值分别为5.519、4.325,P<0.001)。结论经阴道分娩时宫缩及产道挤压使胎儿促甲状腺激素、甲状腺素、游离甲状腺素水平升高,三碘甲状腺原氨酸、游离三碘甲状腺原氨酸水平降低;器械助产不影响新生儿脐血甲状腺功能。Objective To investigate influences of delivery patterns on levels of TSH, T3, T4, FT3, FT4 in cord blood of the newborn, Methods 120 parturients without any pregnancy-associated diseases and complications and without fetal distress, neonatal malformation who delivered in Weifang Municipal Maternal and Child Health Hospital of Shandong province over a period from January to December of the year 2006 were randomly selected and divided into normal delivery group and fetal head vacuum extraction obstetric group and selected cesarean section group according to their delivery patterns, The umbilical arterial blood samples were taken immdiately after cutting the umbilical cord from placenta and the levels of TSH, T3 , T4, FT3 and FT4 were detected, Results The level of TSH in normal delivery group was 14.50 ±1.87μIU/mL and that in the vacuum extraction of fetal head group was 13.97 ± 1. 68μIU/mL, there was no significant difference between the two groups （ t = 1.333, P 〉 0.05 ）, while that in the cesarean section group was 7.47 ± 2. 12μIU/mL and there was a very significant difference as compared with that in another two groups （ t = 15.728, 15.197 respectively, both P 〈 0.001 ）, The level of T3 in the normal delivery group was 0. 88 ±0. 24nmol/L and that in the vacuum extraction of fetal head group was 0.84±0.21nmol/L, there was no difference between the two groups（ t = 0.793, P 〉 0.05 ）, while that in the selected cesarean section group was 0. 76 ± 0. 16nmol/L, there was significant difference as compared with that in another two groups （t =2.631, 1.916, respectively, both P 〈0. 05 ）, The level of FT3 in the normal delivery group was 2. 85 ± 0. 56pmol/L and that in the vacuum extraction of fetal head group was 2.83± 0. 52pmol/L, there was no significant difference between the two groups（ t = 0.166, P 〉 0. 05 ） , while that in the selected cesarean section group was 2.64 ±0. 46pmol/L, there was significant differences as compared with that in another two groups （t = 1.833, 1

关 键 词：分娩方式 新生儿 脐血 甲状腺激素 促甲状腺激素 

分 类 号：R722.19[医药卫生—儿科]