甲状腺素替代疗法对早产儿暂时性低甲状腺素血症的疗效分析  

Analysis of therapeutic effect of thyroid hormone replacement therapy on temporary hypothyroidism in premature infants

作　　者：闫焕利 孟祥鹏 闫瑞雪 郭祥丽 彭富栋[1] 史静[1] YAN Huan-li;MENG Xiang-peng;YAN Rui-xue(Liaocheng Second People's Hospital,Liaocheng 252600,China)

机构地区：[1]聊城市第二人民医院,252600

出　　处：《中国现代药物应用》2025年第5期30-34,共5页Chinese Journal of Modern Drug Application

摘　　要：目的探究对早产儿暂时性低甲状腺素血症应用甲状腺素替代疗法治疗的临床效果。方法选取78例暂时性低甲状腺素血症早产儿,以抽签法分为对照组(39例)与研究组(39例)。对照组以常规支持疗法治疗,研究组在对照组基础上以甲状腺素替代疗法治疗。对比两组甲状腺素[促甲状腺激素(TSH)、血清游离三碘甲状腺原氨酸(FT_(3))、游离四碘甲状腺原氨酸(FT_(4))、三碘甲状腺原氨酸(T_(3))以及四碘甲状腺原氨酸(T_(4))]水平、治疗时间、不良反应发生情况以及预后效果。结果治疗前,两组患儿TSH、FT_(3)、FT_(4)、T_(3)以及T_(4)水平对比无显著差异(P>0.05);治疗后,研究组患儿TSH(4.24±0.56)mIU/L低于对照组的(5.83±0.84)mIU/L,FT_(3)(3.87±0.39)pmol/L、FT_(4)(7.82±0.59)pmol/L、T_(3)(1.68±0.42)nmol/L以及T_(4)(108.23±14.84)nmol/L显著高于对照组的(3.16±0.28)pmol/L、(7.15±0.50)pmol/L、(1.18±0.34)nmol/L、(87.24±12.47)nmol/L,差异有统计学意义(P<0.05)。研究组患儿全肠胃喂养时间为(15.51±2.73)d、恢复体重时间为(8.82±1.94)d、喂养不耐受时间为(11.12±4.27)d、住院时间为(23.21±2.16)d,均短于对照组的(18.39±2.76)、(10.75±1.97)、(14.26±6.73)、(30.76±2.48)d,差异具有统计学意义(P<0.05)。研究组患儿身长、体质量、头围、骨龄落后以及发育商(DQ)偏低占比分别为5.13%、2.56%、2.56%、2.56%、5.13%,均显著低于对照组的20.51%、17.95%、15.38%、17.95%、23.08%,差异具有统计学意义(P<0.05)。两组不良反应发生率对比无显著差异(P>0.05)。结论甲状腺素替代疗法治疗早产儿暂时性低甲状腺素血症能够有效改善其甲状腺素水平,有利于提升预后效果、缩短治疗时间,且不易引发不良反应,使用安全性较高。Objective To explore the clinical effect of thyroid hormone replacement therapy on temporary hypothyroidism in premature infants.Methods 78 premature infants with temporary hypothyroidism were selected and divided into a control group(39 cases)and a study group(39 cases)by lottery method.The control group was treated with conventional supportive therapy,while the study group was treated with thyroid hormone replacement therapy.The levels of thyroxine[thyroid stimulating hormone(TSH),serum free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),triiodothyronine(T_(3))and thyroxine(T_(4))],treatment duration,occurrence of adverse reactions and prognosis of the two groups were compared.Results Before treatment,there were no significant differences in TSH,FT_(3),FT_(4),T_(3)and T_(4)levels between the two groups(P>0.05).After treatment,the study group had a lower TSH of(4.24±0.56)mIU/L in than(5.83±0.84)mIU/L in the control group;the study group had FT_(3)of(3.87±0.39)pmol/L,FT_(4)of(7.82±0.59)pmol/L,T_(3)of(1.68±0.42)nmol/L and T_(4)of(108.23±14.84)nmol/L,which were significantly higher than(3.16±0.28)pmol/L,(7.15±0.50)pmol/L,(1.18±0.34)nmol/L and(87.24±12.47)nmol/L in the control group;the difference was statistically significant(P<0.05).In the study group,the total gastrointestinal feeding time was(15.51±2.73)d,the weight recovery time was(8.82±1.94)d,the feeding intolerance time was(11.12±4.27)d,and the hospital stay was(23.21±2.16)d,which were shorter than(18.39±2.76),(10.75±1.97),(14.26±6.73),and(30.76±2.48)d in the control group,and the difference was statistically significant(P<0.05).The percentages of children with backward length,backward body mass,backward head circumference,backward bone age and low developmental quotient(DQ)in the study group were 5.13%,2.56%,2.56%,2.56%,2.56%and 5.13%,which were significantly lower than 20.51%,17.95%,15.38%,17.95%and 23.08%in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the comparison of

关 键 词：甲状腺素替代疗法 早产儿 暂时性低甲状腺素血症 甲状腺素水平 预后效果 

分 类 号：R722.6[医药卫生—儿科]