中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2013年
8期
607-611
,共5页
缪克凡%段蔚%钱燕%陈大庆
繆剋凡%段蔚%錢燕%陳大慶
무극범%단위%전연%진대경
婴儿,早产%三碘甲状腺原氨酸%暂时性低甲状腺素血症
嬰兒,早產%三碘甲狀腺原氨痠%暫時性低甲狀腺素血癥
영인,조산%삼전갑상선원안산%잠시성저갑상선소혈증
Infant,premature%Triiodothyronine%Transient hypothyroxinemia
目的 研究早产儿中暂时性低甲状腺素血症和低三碘甲状腺原氨酸(T3)综合征的影响因素.方法 选取出生胎龄为26～ 36周的早产儿418例,在生后2周左右检测甲状腺素(T4)、T3、促甲状腺激素(TSH),根据甲状腺功能将对象分为暂时性低甲状腺素血症(TH)组、低T3综合征组、正常对照组3组.收集20种可能相关的围产期因素,并用卡方检验和logistic回归对影响因素进行分析.结果 分组后TH组49例、低T3综合征组35例、正常对照组334例,TH的患病率为11.7％,低T3综合征的患病率为8.4％.20种因素中,对TH有影响的围产期因素为:男性(OR=1.863,95％ CI0.966～3.594),生后应用白蛋白(OR=2.401,95％ CI 1.294 ～4.455),生后应用多巴胺(OR=3.295,95％ CI 1.110 ～9.783)；对低T3综合征有影响的围产期因素为:男性(OR=2.592,95％ CI 1.171～5.736),出生胎龄≤28周(OR=3.503,95％ CI 1.275 ～9.627).结论 男性、生后应用白蛋白和多巴胺是TH的危险因素；男性和出生胎龄≤28周是低T3综合征的危险因素.应用这些危险因素可以筛选出TH和低T3综合征的高危新生儿,便于制定合理的治疗方案.
目的 研究早產兒中暫時性低甲狀腺素血癥和低三碘甲狀腺原氨痠(T3)綜閤徵的影響因素.方法 選取齣生胎齡為26～ 36週的早產兒418例,在生後2週左右檢測甲狀腺素(T4)、T3、促甲狀腺激素(TSH),根據甲狀腺功能將對象分為暫時性低甲狀腺素血癥(TH)組、低T3綜閤徵組、正常對照組3組.收集20種可能相關的圍產期因素,併用卡方檢驗和logistic迴歸對影響因素進行分析.結果 分組後TH組49例、低T3綜閤徵組35例、正常對照組334例,TH的患病率為11.7％,低T3綜閤徵的患病率為8.4％.20種因素中,對TH有影響的圍產期因素為:男性(OR=1.863,95％ CI0.966～3.594),生後應用白蛋白(OR=2.401,95％ CI 1.294 ～4.455),生後應用多巴胺(OR=3.295,95％ CI 1.110 ～9.783)；對低T3綜閤徵有影響的圍產期因素為:男性(OR=2.592,95％ CI 1.171～5.736),齣生胎齡≤28週(OR=3.503,95％ CI 1.275 ～9.627).結論 男性、生後應用白蛋白和多巴胺是TH的危險因素；男性和齣生胎齡≤28週是低T3綜閤徵的危險因素.應用這些危險因素可以篩選齣TH和低T3綜閤徵的高危新生兒,便于製定閤理的治療方案.
목적 연구조산인중잠시성저갑상선소혈증화저삼전갑상선원안산(T3)종합정적영향인소.방법 선취출생태령위26～ 36주적조산인418례,재생후2주좌우검측갑상선소(T4)、T3、촉갑상선격소(TSH),근거갑상선공능장대상분위잠시성저갑상선소혈증(TH)조、저T3종합정조、정상대조조3조.수집20충가능상관적위산기인소,병용잡방검험화logistic회귀대영향인소진행분석.결과 분조후TH조49례、저T3종합정조35례、정상대조조334례,TH적환병솔위11.7％,저T3종합정적환병솔위8.4％.20충인소중,대TH유영향적위산기인소위:남성(OR=1.863,95％ CI0.966～3.594),생후응용백단백(OR=2.401,95％ CI 1.294 ～4.455),생후응용다파알(OR=3.295,95％ CI 1.110 ～9.783)；대저T3종합정유영향적위산기인소위:남성(OR=2.592,95％ CI 1.171～5.736),출생태령≤28주(OR=3.503,95％ CI 1.275 ～9.627).결론 남성、생후응용백단백화다파알시TH적위험인소；남성화출생태령≤28주시저T3종합정적위험인소.응용저사위험인소가이사선출TH화저T3종합정적고위신생인,편우제정합리적치료방안.
Objective To investigate the influencing factors of transient hypothyroxinemia (THT)and low T3 syndrome (LT3S) in premature infants.Method We have studied 418 premature infants whose gestational age was between 26 and 36 weeks.Serum thyronine (T4),triiodothyronine (T3) and thyrotropin (TSH) of them were detected on the fourteenth day approximately after birth.The patients were divided according to their serum T4,T3 and TSH into 3 groups (transient hypothyroxinemia,low T3 syndrome and normal).Then 20 Perinatal factors which may be associated with THT and LT3S were collected.The factors were analyzed by using Chi-square test and Logistic regression.Result Forty-nine infants were found suffering from THT,35 infants suffering from LT3S,and 334 infants in normal group.The prevalence rate of THT was 11.7％,and the prevalence rate of LT3S was 8.4％.Among the 20 factors,the factors related to the incidence of THT were male gender (OR =1.863,95％ CI 0.966-3.594),albumin (OR =2.401,95％ CI 1.294-4.455),dopamine (OR =3.295,95％ CI 1.110-9.783) and those related to the incidence of LT3S were male gender (OR =2.592,95％ CI 1.171-5.736),gestational age ≤ 28 wk (OR=3.503,95％CI 1.275-9.627).Conclusion Male gender,albumin and dopamine are perinatal risk factors of THT,meanwhile,male gender and gestational age ≤ 28 wk are perinatal risk factors of LT3S.With the use of risk factors identified in our study,it may be possible to separate infants having the highest risk of THT and LT3S,so as to form optimizing treatment strategies.
