甲状腺素替代治疗早产儿暂时性低甲状腺素血症30例临床观察

摘要

Objective To observe the effect of supplement therapy with euthyrox for preterm infants with transient hypothyroxinaemia (THOP).Methods Sixty preterm infants with THOP were divided into treatment group (n =30) and control group (n =30).The infants in both groups were given the same based support treatment.Supplement therapy with euthyrox was added to the infants in treatment group for 14 days.ECL assay was used to detect thyroid hormone levels respectively in all preterm infants.At the corrected gestation age 40 ± 2 week,every infant received a neonatal behavioral neurological assessment (NBNA).Results After the treatment,the serum levels of FT3 and FT4 in treatment group were higher than those before treatment,both P ＜0.01.And in the control group,there was only the serum level of FT3 higher than that before treatment,P ＞0.01.TSH levels in the two groups after treatment compared with before treatment showed no significant difference,P ＞ 0.05.Compared with control group,the infants with suspicious abnormalities of nervous system development in treatment group were fewer,and the NBNA scores were higher,all P ＜0.01.Conclusions The supplement of thyroxine can significantly raise the serum levels of FT3 and FT4 of preterm infants with THOP,and benefits to the development of nervous system of premature infants.%目的 探讨甲状腺素替代治疗对早产儿暂时性低甲状腺素血症(THOP)的疗效.方法 收集60例THOP早产儿,分为治疗组与对照组各30例.两组患儿均给予相同的基础支持治疗,治疗组加予左甲状腺素5μg/(kg·d)口服治疗,共治疗l4 d.采用电化学发光法检测早产儿甲状腺素水平.所有患儿于纠正胎龄时行新生儿行为神经测定(NBNA).结果 治疗后,治疗组FT3、FT4水平比治疗前升高(P均＜0.01),对照组仅FT4比治疗前升高(P＞0.01).两组治疗后TSH水平与治疗前比较差异均无统计学意义(P＞0.05).纠正胎龄40周时,治疗组与对照组比较,神经系统发育可疑异常者较少,NBNA评分较高(P均＜0.01).结论 补充甲状腺素后可使THOP早产儿血清FT3、FT4水平明显升高,有助促进其神经系统发育.