摘要
目的研究血清维生素D水平与小儿先天性甲状腺功能减低症(CH)的相关性。方法回顾性分析芜湖市妇幼保健院2014年1月到2020年12月间确诊为CH且日龄小于28 d的120例患儿的临床资料(甲减组),按照1∶2原则选取同期出生日期不超过30 d、性别相同并排除其他疾病的240例健康新生儿作为对照组。收集所有新生儿的临床资料,比较2组新生儿血清25(OH)D_(3)及甲状腺功能相关指标[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)],分析25(OH)D_(3)与甲减的相关性,并采用logistic回归分析法探讨可能影响CH发生的危险因素。结果甲减组的血清25(OH)D_(3)[(56.74±22.46)nmol/L]、FT3[(8.05±0.99)pmol/L]及FT4[(6.33±0.92)pmol/L]水平均明显低于对照组[(80.63±18.95)nmol/L、(17.97±3.52)pmol/L、(16.49±2.85)pmol/L,P<0.01],血清TSH水平[(28.46±4.82)mU/L]明显高于对照组[(2.29±0.31)mU/L,P<0.01]。新生儿多因素logistic回归分析显示,胎龄(OR=1.25,95%CI=0.396~5.273)、出生体重(OR=2.39,95%CI=1.339~4.184)及Apgar评分(OR=2.08,95%CI=0.481~4.596)均是CH发病的独立危险因素(P<0.05)。Pearson相关分析显示,血清25(OH)D_(3)水平与TSH呈现明显负相关(r=-0.774,P<0.01),与FT3和FT4呈现明显正相关(r=0.691,P<0.01;r=0.715,P<0.01)。结论维生素D缺乏与CH存在相关性,且胎龄、出生体重、Apgar评分可能是CH发生的影响因素。而临床上是否可以通过孕母补充维生素D降低CH的发生率或CH患儿通过补充维生素D辅助原发病的治疗改善甲状腺功能,仍需进一步证实。
Objective To study the association of serum vitamin D levels with congenital hypothyroidism(CH)in children.Methods Clinical data of 360 neonates screened from January 2014 to December 2020 in Wuhu Maternal and Child Health Hospital were retrospectively collected and divided into two groups according to the level of thyroid stimulating hormone(TSH).Serum 25(OH)D_(3)and thyroid function related indexes were detected in hypothyroidism group(120 cases)and control group(240 cases),and the correlation between 25(OH)D_(3)and hypothyroidism [TSH,free triiodine thyrogenine(FT3)and free thyroxine(FT4)]was analyzed.Logistic regression analysis was used to explore the risk factors that may affect the occurrence of CH.Results The serum 25(OH)D_(3)[(56.74±22.46)nmol/L],FT3[(8.05±0.99)pmol/L]and FT4[(6.33±0.92 pmol/L]levels were significantly lower than that in the control group[(80.63±18.95)nmol/L,(17.97±3.52)pmol/L,(16.49±2.85)pmol/L,P<0.01].The serum TSH[(28.46±4.82)mU/L]levels were significantly higher than that in the control group[(2.29±0.31)mU/L,P<0.01].Multivariate logistic regression analysis showed that gestational age(OR=1.25,95%CI=0.396-5.273),birth weight(OR=2.39,95%CI=1.339-4.184)and Apgar score(OR=2.08,95%CI=0.481-4.596)were independent risk factors for CH(P<0.05).Pearson correlation analysis showed that serum 25(OH)D_(3)level was significantly negatively correlated with TSH(r=-0.774,P<0.01),and significantly positively correlated with FT3 and FT4(r=0.691,P<0.01;r=0.715,P<0.01).Conclusion Vitamin D deficiency is correlated with CH,and gestational age,birth weight and Apgar score may be the influencing factors of CH.Whether the incidence of CH can be reduced by vitamin D supplementation in pregnant women or thyroid function can be improved by vitamin D supplementation assisted primary disease treatment in children with CH still needs further confirmation.
作者
潘菲
程锐
张祥生
PAN Fei;CHENG Rui;ZHANG Xiang-sheng(Neonatal Medical Center of Children′s Hospital Affiliated to Nanjing Medical University,Nanjing 210008,Jiangsu,China;Department of Neonatology,Wuhu Maternal and Child Health Hospital,Wuhu 241000,Anhui,China)
出处
《东南国防医药》
2022年第2期162-166,共5页
Military Medical Journal of Southeast China
作者简介
通信作者:程锐,E-mail:chengrui350@163.com。
