低体质量、极低体质量早产儿甲状腺功能减退的诊断标准探讨及临床价值分析  

Diagnostic Criteria and Clinical Value of Hypothyroid in Low and Very Low Weight Premature Infants.

作　　者：梁河涛[1] 叶庭菠 刘华伟[1] 黄潇苇[1] 吴晓丽[1] Liang Hetao;Ye Tingbo;Liu huawei(Laboratory Department,The Third People′s Hospital of Chengdu,Chengdu,Sichuan 610031,China.)

机构地区：[1]成都市第三人民医院检验科,四川成都610031

出　　处：《四川医学》2021年第12期1216-1219,共4页Sichuan Medical Journal

摘　　要：目的探讨低体质量、极低体质量早产儿甲状腺功能低下的筛查切值,及早产儿出生时的胎龄、体质量、性别等对甲状腺功能的影响。方法收集2017年12月至2020年4月在我院新生儿科住院的低体质量、极低体质量早产儿的临床资料,在其出生后2~4周采集患儿血清使用雅培Abbott i2000化学发光分析仪检测血清中TT_(3)、TT_(4)、TSH、FT_(3)、FT_(4)激素水平,分析判断患儿甲状腺激素缺乏状况;同时按出生胎龄<32周、或≥32周、及出生时体质量<1.5 kg(极低体质量)、或≥1.5 kg而<2.5 kg(低体质量)以及性别分组,探讨出生时胎龄、体质量、性别因素所致的早产儿甲状腺功能低下的患病率状况。结果215例早产的低体质量、极低体质量患儿在本院的诊断标准中提高了接受甲状腺素替代治疗比例。在不同胎龄、体质量和性别分组中,胎龄<32周的早产儿甲状腺功能减退患病率明显高于胎龄≥32周的早产儿(P<0.05),极低体质量早产儿的甲状腺功能减退患病率明显高于低体质量早产儿(P<0.05),而低体质量、极低体质量患儿中男婴和女婴甲状腺功能减退患病率无统计学差异。结论对早产儿应做甲状腺激素的普查,特别对低胎龄、极低体质量早产儿的甲状腺激素更应进行重点筛查,尽早及时的干预治疗不仅可促进早产儿各器官的成熟和发育又可预防或减少呆小症及脑瘫的发病率。Objective To study low and very low weight premature infants with hypothyroidism screening cut-off,and effects of gestational age,weight and gender on thyroid function.Method From December 2017 to April 2020,clinical data of low and very low weight premature infants hospitalized in our hospital were collected.Abbott i2000 chemiluminescence analyzer was used to detect serum TT_(3),TT_(4),TSH,FT_(3),FT_(4).According to gestational age,they were divided into two groups of<32 weeks and≥32 weeks.According to birth weight,they were divided into two groups:very low weight(<1.5 kg)and low weight(<2.5 kg but≥1.5 kg).And they were divided into two groups according to gender:male and female baby.Effects of gestational age,weight and gender on hypothyroidism prevalence in preterm infants were analyzed separately.Results 215 premature low and very low weight children increased ratio of thyroxine replacement therapy in our hospital's diagnostic criteria.In different gestational age,weight and gender groups,ratio of hypothyroidism in preterm infants with gestational age<32 weeks was significantly higher than that in preterm infants with gestational age≥32 weeks(P<0.05).Prevalence of hypothyroidism was significantly higher in very low weight preterm infants than that of low weight preterm infants(P<0.05).There was no statistically significant difference in prevalence of hypothyroidism among male and female infants in low weight and very low weight children.Conclusion Premature infants with low gestational age and very low weight should be screened,and treatment should be carried out as soon as possible to promote physical growth and intellectual development.

关 键 词：低体质量 极低体质量 早产儿 甲状腺功能低下 患病率 

分 类 号：R722.19[医药卫生—儿科]