新生儿缺氧缺血性脑病患儿血清甲状腺激素水平变化的临床意义  

Clinical significance of thyroid hormones in neonatal hypoxic ischemic encephalopathy

作　　者：戴永利 王君霞 郭林梅 赵晓云 郭俊宇 DAI Yongli;WANG Junxia;GUO Linmei;ZHAO Xiaoyun;GUO Junyu(Departmant of Pediatrics,the 940th Hospital of Joint Logistic Support Force of PLA, Lanzhou 730050,China)

机构地区：[1]解放军联勤保障部队第940医院儿科,甘肃兰州730050

出　　处：《西北国防医学杂志》2020年第5期312-315,共4页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:探讨新生儿缺氧缺血性脑病(hypoxic ischemic encephalopathy,HIE)患儿血清甲状腺激素水平变化的临床意义。方法:选取我院2017-01-01~2019-01-01新生儿科确诊为HIE的住院患儿72例为HIE组,按照《实用新生儿学》中诊断标准将其分为轻度组(n=28)、中度组(n=25)和重度组(n=19)。另选取72例健康新生儿为对照组,检测各组血清总三碘甲状腺原氨酸(total triiodothyroionine,TT3)、总四碘甲状腺原氨酸(total tetraiodothyronine,TT4)、游离三碘甲状腺原氨酸(free triiodothyroionine,FT3)、游离四碘甲状腺原氨酸(free tetraiodothyronine,FT4)、促甲状腺素(thyroid-stimulating hormone,TSH)水平。结果:HIE组TT3、FT3水平明显低于对照组(P<0.01),两组的TT4、FT4、TSH比较,差异无统计学意义(P>0.05)。与轻度组比较,中度组TT3、FT3水平明显下降(P<0.05),两组的TT4、FT4、TSH比较,差异无统计学意义(P>0.05);与中度组比较,重度组的TT3、FT3、TT4、FT4均明显降低,差异有显著统计学意义(P<0.01)。HIE组治疗后TT3、TT4、FT3及FT4水平均较治疗前显著升高(P<0.01)。结论:HIE患儿甲状腺激素水平异常,通过测定甲状腺激素水平可评估HIE患儿病情的严重程度,判断治疗效果。Objective:To explore the clinical significance of thyroid hormones in neonatal hypoxic ischemic encephalopathy(HIE).Methods:Seventy-two children with HIE from January 2017 to January 2019 in our hospital as HIE group,and who were randomly divided into mild group(n=28),moderate group(n=25)and severe group(n=19)according to the practical neonatal diagnostic criteria.Seventy-two healthy newborn during the same period as the control group.The serum levels of total triiodothyroionine(TT3),total tetraiodothyronine(TT4),free triiodothyroionine(FT3),free tetraiodothyronine(FT4),thyroid-stimulating hormone(TSH)were measured.Results:The TT3、FT3 in HIE group were significantly lower than those of control group(P<0.01),the levels of TT4、FT4、TSH were no difference between the two groups(P>0.05).The levels of TT3、FT3 of moderate group were significantly lower than those of mild group(P<0.05),the levels of TT4、FT4、TSH were no difference between the two groups(P>0.05).The levels of TT3、FT3、TT4、FT4 of severe group were significantly lower than those of moderate group(P<0.01).After treatment,the level of TT3,FT3,FT4 in HIE group were significantly higher than before treatment.Conclusion:Serum thyroid hormones is exists in children with HIE,the levels of serum thyroid hormones of HIE at acute stage can reflect the disease severity,and the changes of serum thyroid hormones can evaluate the treatment effects of HIE.

关 键 词：新生儿缺氧缺血性脑病 甲状腺激素 正常甲状腺功能病态综合征 

分 类 号：R722.1[医药卫生—儿科]