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目的探讨足月新生儿窒息后血清甲状腺激素水平的变化及其临床意义。方法采用化学发光法测定52例足月窒息新生儿(重度窒息20例、轻度窒息32例)和35例健康足月儿出生1天及10天的血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺激素(TSH)含量,并观察其动态变化。结果生后第1天窒息组FT3、FT4明显低于对照组(P<0.01),重度窒息组低于轻度窒息组(P<0.05);重度窒息组TSH明显高于对照组(P<0.01),轻度窒息组与对照组间TSH差异无统计学意义(P>0.05)。10天后各组FT3、FT4、TSH差异无统计学意义(P>0.05)。生后1天时窒息组FT3、FT4低于正常值的比例和TSH高于正常值的比例均高于对照组(P<0.05),轻度窒息组FT3、FT4低于正常值的比例高于对照组(P<0.05),TSH高于正常值的比例与对照组比较差异无统计学意义(P>0.05),生后10天时各组各指标异常率差异无统计学意义(P>0.05)。结论新生儿窒息可导致甲状腺功能受损,且随窒息程度加重而加重,血清甲状腺激素水平对判断窒息新生儿病情及观察疗效有一定意义。
Objective To investigate the changes of serum thyroid hormones after full-term neonatal asphyxia and its clinical significance. Methods The levels of serum free triiodothyronine (FT3) in 52 full-term asphyxia neonates (20 severe asphyxia and 32 mild asphyxia) and 35 healthy full-term infants were measured at 1 day and 10 days after birth by chemiluminescence method. , Free thyroxine (FT4) and thyroid stimulating hormone (TSH), and observe its dynamic changes. Results The levels of FT3 and FT4 in asphyxia group were significantly lower than those in control group (P <0.01), those in severe asphyxia group were lower than those in mild asphyxia group (P <0.05). The TSH in severe asphyxia group was significantly higher than that in control group (P <0.01) ), Mild asphyxia group and control group TSH difference was not statistically significant (P> 0.05). After 10 days, there was no significant difference in the FT3, FT4 and TSH between the groups (P> 0.05). The proportion of FT3 and FT4 below normal value and TSH higher than normal value in asphyxia group were higher than those in control group (P <0.05) at 1 day after birth, and those in mild asphyxia group were lower than those in control group (P <0.05). There was no significant difference in the percentage of TSH between the two groups (P> 0.05). There was no significant difference in each index between 10 days after birth (P> 0.05). Conclusions Neonatal asphyxia can lead to impaired thyroid function and aggravate with the degree of asphyxia. Serum thyroid hormone level is of certain significance in judging the condition of neonatal asphyxia and observation of curative effect.