早产儿甲状腺功能变化及其临床检测价值分析  

Changes and clinical value of thyroid function in premature infants

作　　者：张冰[1] 陈鹏[1] 张成云[1] 陈海燕[1] 安丽花[1] 李晓艳[1] ZHANG Bing;CHEN Peng;ZHANG Cheng-yun;CHEN Hai-yan;AN Li-hua;LI Xiao-yan(Zhengzhou First People's Hospital,Henan 450052,China)

机构地区：[1]郑州市第一人民医院,河南450052

出　　处：《中国卫生检验杂志》2022年第23期2817-2821,2825,共6页Chinese Journal of Health Laboratory Technology

基　　金：河南省医学科技攻关计划项目(LHGJ20190992)。

摘　　要：目的 探讨早产儿甲状腺功能变化及其临床检测价值。方法 收集2019年1月—2021年6月本院收治的早产儿(胎龄<37周)326例为研究对象,检测早产儿甲状腺功能指标[血清三碘甲状腺原氨酸(T_(3))、甲状腺素(T_(4))、游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺素(TSH)],根据早产儿疾病状态分为观察组(早产儿,n=89)及对照组(正常早产儿,n=237),观察组患儿依据病情程度分为危重组(n=13)和非危重组(n=76)。比较各组临床资料和血清甲状腺功能指标,采用受试者工作特征曲线(ROC曲线)分析甲状腺功能指标对早产儿疾病状态预测价值。结果 观察组血清FT_(3)、FT_(4)、TSH、T_(3)、T_(4)低于对照组(P<0.05)。随胎龄增加早产儿血清FT_(3)、FT_(4)、TSH、T_(3)、T_(4)增高(P<0.05)。ROC曲线分析提示,甲状腺功能指标五项联合检测预测早产儿的曲线下面积、特异度高于单项检测。logistic回归分析提示,胎龄、呼吸窘迫综合征、缺血缺氧性脑病、妊娠期糖尿病、妊娠期高血压、血清T_(3)、T_(4)、FT_(3)、FT_(4)、TSH是疾病状态早产儿病情程度的危险因素(P<0.05)。由危险因素构建的预测模型预测疾病状态早产儿病情程度的敏感度、特异度分别为95.83%、81.48%,曲线下面积为0.848。结论 甲状腺功能与早产儿疾病状态具有相互影响的关系,并与早产儿胎龄直接相关,胎龄、呼吸窘迫综合征、妊娠期糖尿病及甲状腺功能指标等构建的预测模型对疾病状态早产儿病情程度有一定预测价值。Objective This study aims to investigate the changes and clinical value of thyroid function in premature infants. Methods A total of 326 premature infants(gestational age less than 37 weeks) admitted to Zhengzhou First People’s Hospital were selected as the research subjects between January 2019 and June 2021. Thyroid function indexes [serum triiodothyronine(T_(3)), thyroxine(T_(4)), free triiodothyronine(FT_(3)), free thyroxine(FT_(4)), thyroid stimulating hormone(TSH)] were detected. The subjects were divided into observation group(premature infants, n=89) and control group(normal premature infants, n=237). According to disease severity, premature infants in observation group were divided into critical group(n=13) and non-critical group(n=76). The clinical data and serum thyroid function indexes were compared between the groups. The predictive value of thyroid function indexes in premature infants was analyzed using the receiver operating characteristic(ROC) curve. Results The levels of serum FT_(3), FT_(4), TSH, T_(3)and T_(4)in observation group were lower than those in control group(P<0.05). With the increase of gestational age, serum FT_(3), FT_(4), TSH, T_(3)and T_(4)in premature infants increased(P<0.05). ROC curve analysis indicated that the area under the curve(AUC) and specificity of joint prediction of the five thyroid function indexes were greater than those of single indexes. Logistic regression analysis indicated that gestational age, respiratory distress syndrome, hypoxic-ischemic encephalopathy, gestational diabetes mellitus, gestational hypertension, serum T_(3), T_(4), FT_(3), FT_(4)and TSH were risk factors influencing the condition of premature infants under disease status(P<0.05). The sensitivity, specificity and the area under the curve of the prediction model constructed based on the risk factors to predict the condition of premature infants under disease status were 95.83%, 81.48% and 0.848. Conclusion Thyroid function has an interactive relationship with the disease status of preterm i

关 键 词：早产儿 甲状腺功能 疾病状态 价值 

分 类 号：R722[医药卫生—儿科]