北京地区某三甲医院早产儿甲状腺激素变化及其参考区间的探讨OA

Objective To analyze the developmental characteristics of thyroid function in premature infants and establish reference intervals for thyroid hormone levels in infants of different gestational ages.Methods A retrospective analysis was conducted on the clinical data of 2 827 neonates admitted to the Department of Neonatology,the Seventh Medical Center of Chinese PLA General Hospital from January 2017 to December 2022.The neonates were divided into four groups based on gestational age:extremely premature infants(gestational age<28 weeks,n=122),very premature infants(gestational age 28-31+6 weeks,n=631),premature infants(gestational age 32-36+6 weeks,n=1 881),and full-term infants(gestational age>37 weeks,n=193).Chemiluminescent immunoassay was used to detect the thyroid hormone levels.The levels of thyroid-stimulating hormone(TSH),triiodothyronine(T3),tetraiodothyronine(T4),free triiodothyronine(FT3),and free tetraiodothyronine(FT4)were compared among neonates of different gestational ages,genders,postnatal ages,and corresponding reference intervals were established.Statistical analysis was performed using independent samples t-test,χ² test,One-way analysis of variance(ANOVA),Mann-Whitney U test,and Kruskal-Wallis H test.Results There were statistically significant differences in TSH,T3,T4,FT3,and FT4 levels among the different gestational age groups(all P<0.05).Within each gestational age group,gender differences were observed in some thyroid hormones:T4 in very premature infants;T3,T4,FT3,and FT4 in premature infants;and T4 in full-term infants(all P<0.05).Therefore,reference intervals for thyroid hormones in premature infants were established by grouping according to gestational age and gender.Conclusion Thyroid hormone levels in premature infants are significantly dependent on gestational age and gender.This study established reference intervals of thyroid hormone stratified by gestational age,which can provide a basis for the early clinical identification of thyroid dysfunction.