7日龄住院早产儿甲状腺功能影响因素及参考值范围探讨

Investigation of influencing factors and reference ranges for thyroid function in hospitalized preterm infants at the age of 7 days

摘要:

目的 探讨7日龄早产儿甲状腺功能的影响因素及其参考值范围，以避免临床上不必要的复查和干预。方法 回顾性分析2020年1月—2023年1月住院的685例早产儿资料。依据胎龄和出生体重分为高危组（胎龄<34周或体重<2 000 g；n=228）与低危组（胎龄≥34周且出生体重≥2 000 g；n=457）。分析甲状腺功能的影响因素，并计算其95%参考值范围。结果 多元线性回归分析显示，胎龄、出生体重、出生季节、性别、辅助生殖等为甲状腺功能的影响因素（P<0.05）。高危组早产儿的游离三碘甲状腺原氨酸（free triiodothyronine, FT3）、游离甲状腺素（free thyroxine, FT4）、总三碘甲状腺原氨酸（total triiodothyronine, TT3）、总甲状腺素（total thyroxine, TT4）、促甲状腺激素（thyroid stimulating hormone, TSH）参考值范围分别为2.79~5.40 pmol/L、8.80~25.64 pmol/L、0.80~2.15 nmol/L、50.06~165.09 nmol/L、0.80~18.57 μIU/mL，低危组的分别为3.08~5.93 pmol/L、11.17~26.24 pmol/L、1.02~2.27 nmol/L、62.90~168.95 nmol/L、0.69~13.70 μIU/mL。FT3、FT4、TT3、TT4与胎龄呈正相关（P<0.05）；FT3、FT4、TT3、TT4与出生体重呈正相关（P<0.05），TSH与出生体重呈负相关（P<0.05）。结论 7日龄早产儿甲状腺功能受胎龄、出生体重等因素影响；7日龄早产儿甲状腺功能参考值范围应基于胎龄及出生体重建立。

Abstract:

Objective To investigate the influencing factors and reference ranges for thyroid function in preterm infants at the age of 7 days, with the aim of avoiding unnecessary clinical reexamination and intervention.Methods A retrospective analysis was performed for the data of 685 preterm infants from January 2020 to January 2023. According to gestational age and birth weight, they were divided into a high-risk group (gestational age <34 weeks or birth weight<2 000 g; 228 infants) and a low-risk group (gestational age ≥34 weeks and birth weight ≥2 000 g;457 infants). The influencing factors for thyroid function were analyzed, and 95% reference range was calculated.Results Gestational age, birth weight, birth season, sex, and assisted reproduction were the influencing factors for thyroid function (P<0.05). For the preterm infants in the high-risk group, the reference ranges of free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), total thyroxine (TT4), and thyroid stimulating hormone (TSH) were 2.79-5.40 pmol/L, 8.80-25.64 pmol/L, 0.80-2.15 nmol/L, 50.06-165.09 nmol/L, and 0.80-18.57 μIU/mL, respectively. For those in the low-risk group, the reference ranges of these indicators were 3.08-5.93 pmol/L, 11.17-26.24 pmol/L, 1.02-2.27 nmol/L, 62.90-168.95 nmol/L, and 0.69-13.70 μIU/mL, respectively. FT3, FT4, TT3, and TT4 were positively correlated with gestational age (P<0.05); FT3, FT4, TT3, and TT4 were positively correlated with birth weight (P<0.05); TSH was negatively correlated with birth weight (P<0.05).Conclusions Thyroid function in preterm infants at the age of 7 days is affected by the factors such as gestational age and birth weight, and the reference ranges of thyroid function in preterm infants at the age of 7 days should be established based on gestational age and birth weight.