Transient hypothyroxinemia, brain injury and neuroethology in preterm infants
10.3760/cma.j.issn.1673-4912.2011.04.014
- VernacularTitle:早产儿暂时性低甲状腺素血症与脑损伤及神经行为学相关性研究
- Author:
Jingyi SHI
;
Gang QIU
- Publication Type:Journal Article
- Keywords:
Transient hypothyroxinemia;
Periventricular leukomalacia;
Neonatal behavioral neurological assessment;
Premature infants
- From:
Chinese Pediatric Emergency Medicine
2011;18(4):332-334
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyse the associativity among serum thyroid hormone level,brain injury and neuroethology in preterm infants by testing the thyroid hormone level and neuro-behaviour assessment.Methods Fifty-two preterm infants were continuously admitted in neonatal department of Shanghai Children's Hospital from Dec 2009 to Apr 2010. Radio-immunity was used to determine the serum level of T3,T4, TSH within 6 h after birth. Each case received cranial ultrasonic examination within 3 d after birth and rechecked every week. Before discharge, every infant received a cranial MRI examination. The 52 cases were devided into three groups according to the result of ultrasound and MRI:no brain damage group (33 cases),intraventricular hemorrhage greup (10 cases) ,and white matter injury group (9 cases). At the corrected gestation age 40±2 weeks,every infant received a neonatal behavioral neurological assessment (NBNA). Results The level of serum TSH in all the three groups of preterm infants were normal, which could reject congenital hypothyroidism. Eight preterm infants(15.4% ,8/52) had normal thyroid hormone level,another 44 preterm infants(84. 6% ,44/52) got lower thyroid functions. The levels of T3 and T4 were higher in the no brain damage group than those in intraventricular hemorrhage group and white matter injury group. And the preterm infants who had white mauer injury got the lowest level of thyroine hormone T3 and T4. Thyroxine hormone levels had significant difference among three groups (P ＜ 0. 05). The preterm infants who had no brain damage got higher scores in capability, passive muscle tonus,initiative muscle tonus and total score than the other two groups. Intraventricular hemorrhage group always got higher scores in NBNA than the white matter injury group (P ＜ 0. 05). The NBNA scores had significant difference among three groups (P ＜ 0. 05). Conclusion Premature infant who has more severe brain injury always has lower levels of thyroxine hormone. Premature infants with brain injury get lower scores in NBNA test than those without brain injury.
