早产儿甲状腺激素水平及颅内出血风险性相关探究.docVIP

早产儿甲状腺激素水平及颅内出血风险性相关探究[摘要] 目的 探讨早产儿甲状腺激素水平与颅内出血(ICH)风险的相关性。方法 采用头颅彩超对157例早产儿进行检查,同时使用时间分辨荧光免疫分析法测定早产儿的血清游离T3(FT3)、游离T4(FT4)、促甲状腺素(TSH )水平。结果 157例早产儿中确诊82例(52.23%)患儿颅内出血。颅内出血早产儿血清FT4水平为(9.71±3.45) pmol#8226;L?-1?,无颅内出血早产儿为(12.67±4.03) pmol#8226;L?-1?,两组比较差异有统计学意义(P0.05)。低血清FT4患儿97例,其中颅内出血组58例(占59.8%),低血清FT4增加早产儿颅内出血的风险,OR=2.23,95%CI:1.16～4.30;低血清FT3患儿103例,其中颅内出血组62例(占60.2%),低血清FT3增加早产儿颅内出血的风险,OR=2.57,95%CI:1.30～5.07。结论 血清甲状腺激素水平与早产儿颅内出血具有相关性,低血清FT3、FT4水平增加早产儿颅内出血的风险。? [关键词] 甲状腺激素;婴儿;早产;颅内出血? [中图分类号] R722.19;?O212.1[文献标识码] A [文章编号] 1671-7562(2009)06-0407-04?? Related research of serum thyroxine levels in premature infants and ?the risk of intracranial hemorrhage?? CHEN Yu?Lin,HAN Shu?Ping,YU Zhang?bin,DONG Xiao?yue (Department of Pediatrics,Nanjing Maternity and Child Health Hospital,Nanjing Medical University,Nanjing 210004,China)?? Abstract:Objective To explore the relation of serum thyroxine levels in premature infants and the risk of intracranial hemorrhage (ICH).Methods One hundred and fifty?seven premature infants received cranial ultrasound examinations,the levels of serum free triiodothyronine (FT3),free thyroxine (FT4),thyroid?stimulating hormone (TSH ) were determined by a time?resolved fluorescence immunoassay.Results 52.23%(82 cases?) were found to have ICH.The level of serum FT4 in infant with ICH was(9.71±3.45) pmol#8226;L?-1?,the level of serum FT4 in infant without ICH was(12.67±4.03) pmol#8226;L?-1 ?,which was significantly higher than that in infant with ICH(P0.05].Ninty?seven cases were found to have lower FT4 value,which was associated with an increased the risk of ICH [Odds ratio (OR)=2.23?,95%CI:1.16～4.30,P 1 对象和方法? 1.1 研究对象? 研究对象为2008年5月至2009年4月由于早产、器官发育不成熟、生活能力不足而住院进行护理和喂养的早产儿,胎龄(31.72±2.41)周,选择出生体重在1?000~2?000?g之间、无胎儿宫内窘迫、窒息及感染史的早产儿。母亲患有甲状腺疾病、怀疑为先天性甲状腺功能低下及证实有其他遗传代谢性疾病患儿被剔除。采用双盲法随机抽取157例早产儿进行甲状腺素水平测定和头颅超声检查。依据超声检查结果分为颅内出血组和无颅内出血组。? 1.2 甲状腺激素水平测定? 两组早产儿均于生后2～6?d抽取清晨空腹股静脉血2?ml,及时分离血清,置2~8?℃冰箱保存,1周