摘要
下丘脑-垂体-甲状腺轴在胎龄30~35周逐渐发育成熟。随着早产儿救治水平的提高,存活早产儿的胎龄逐渐降低,低龄早产儿甲状腺轴发育不成熟,同时早产儿更容易发生各系统并发症,如缺血缺氧、严重感染等,加重对甲状腺的影响。临床上发现越来越多的早产儿合并先天性甲状腺功能减低症、暂时性低甲状腺素血症、高促甲状腺激素血症、延迟促甲状腺激素升高、低T3综合征等问题。甲状腺功能异常影响着早产儿疾病的治疗及转归,早发现、早治疗是改善早产儿治疗、代谢、发育的关键。目前早产儿甲状腺疾病筛查及治疗时机尚存在争议。该文综述不同病理状态下早产儿甲状腺功能及转归,为临床上合理选择甲状腺疾病筛查时机及治疗策略提供可靠依据。
The hypothalamic-pituitary-thyroid axis gradually becomes mature at gestational age of 30~35 weeks.With the improvement of the treatment level of premature infants,the gestational age of surviving premature infants gradually decreases,and the thyroid axis of young premature infants is immature.Meanwhile,premature infants are more prone to systemic complications,such as ischemia and hypoxia,severe infection,etc.,which aggravate the influence on thyroid.Clinically,more and more premature infants are found to be complicated with congenital hypothyroidism,temporary hypothyroxemia,hyperthyrotropin,delayed thyrotropin elevation,low T3 syndrome and other problems.Abnormal thyroid function affects the outcome of the treatment of premature infant diseases.Early detection and early treatment is the key to improve the treatment,metabolism and the development of premature infant.At present,the timing of screening and treatment of premature thyroid disease is still controversial.In this review,the thyroid function and outcome of premature infants under different pathological conditions are summarized and analyzed to provide a reliable basis for rational selection of screening opportunities and treatment strategies for thyroid diseases in clinical practice.
作者
张聪(综述)
郑荣秀(审校)
Zhang Cong;Zheng Rongxiu(Department of Pediatrics,Tianjin Medical Univeysity General Hospital,Tianjin 300052,China)
出处
《国际儿科学杂志》
2022年第1期52-57,共6页
International Journal of Pediatrics
基金
天津市环境营养与人群健康重点实验室开放课题(2020ENKL05)。
关键词
早产儿
甲状腺
胚胎发生
新生儿筛查
转归
Premature infants
Thyroid
Embryogenesis
Neonatal screening
Outcomes
