- 期刊
Thyroid Function in the Sick Very Low-Birth-Weight Infants
極低出生體重早產病兒四狀腺功能之研究
摘要
本研究的目的在於探討極低出生體生早產兒出生後甲狀腺功能的變化。針對100名極低出生體重的早產兒，在新生兒期進行一系列的血中甲狀腺素thyroxine(T4)、游离甲狀素free T4、三碘甲狀腺素triiodothyronine(T3)、甲狀腺激素thyroid-stimulating hormone(TSH)的檢測。共有89名參與研究的早產兒存活至出院，11名於住院期間死亡。有41名(46.1%)存活者發生暫性的低甲狀腺素血症。有1名存活者的資料分析顯示，在6個星期的研究期間，平均血中TSH濃度都在正常範圍內。血中T4及free T4的濃度則在出生1天以後下降，於7天時達到最低點，之後持續上升。臍帶血中的T3濃度相當低，出生後血中的T3濃度則隨時間而持續上升。本研究也發現，低下的T4血中濃度與病人死亡及罹病情形有關。低甲狀腺素血症與病人危急的病況有所關聯。總結而言，極低出生體重早產兒出生後之甲狀腺功能變化是相當特別的，暫性低甲狀腺素血症常發生在這群病人身上。甲狀腺功能與死亡，新生兒疾病及其後神經發展預後之間的關系則需要更進一步的研究。
並列摘要
This study was undertaken to determine postnatal changes in thyroid function in very low-birth- weight (VLBW) infants. A total of one-hundred VLBW infants participated. Serial examination of serum levels of thyroxine (T4), free T4, triiodothyronine (T3), and thyroid-stimulating hormone (TSH) was performed in the neonatal period. A total of eighty-nine infants survived to discharge, while eleven died during hospitalization. Transient hypothyroxinemia was found in forty-one (46.l percent) of the survivors. One of the surviving infants had primary hypothyroidism. His data was excluded from the analysis. In the other eighty-eight surviving infants, TSH levels were within normal limits throughout the six-week study period. T4 and free T4 values decreased after the first day of life, reaching a nadir at one week of age, followed by progressive increases. The mean cord blood T3 level was very low; the serum T3 value increased progressively in the postnatal period. We found a correlation between low T4 and free T4 values and mortality and neonatal illness. Hypothyroxinemia was associated with critical illness. In conclusion, the postnatal changes in thyroid function in VLBW infants were characteristic, with transient hypothyroxinemia being common in these infants. Further investigation of the relationship between thyroid function, death, neonatal illness, and developmental outcome is warranted.
延伸閱讀
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