双胎早产儿之一合并暂时性低甲状腺素血症的影响因素分析

doi:10.3760/cma.j.cn113903-20230817-00123

科研成果详情

题名	双胎早产儿之一合并暂时性低甲状腺素血症的影响因素分析
其他题名	Factors influencing transient hypothyroxinemia in one premature twin
作者	林蓓蓓 1; 缪克凡2; 林威1
发表日期	2023-10-16
发表期刊	中华围产医学杂志影响因子和分区
语种	中文
原始文献类型	Periodical
关键词	甲状腺功能减退症婴儿，早产双胎甲状腺素促甲状腺素
其他关键词	Hypothyroidism ; Infant, premature ; Twins ; Thyroxine ; Thyrotropin
摘要	目的:研究双胎早产儿之一合并暂时性低甲状腺素血症（transient hypothyroxinemia，TH）的影响因素。方法:回顾性选取2009年6月至2021年9月在温州医科大学附属第二医院新生儿科收治的出生胎龄26~36周的283对双胎早产儿，在生后11~20 d检测甲状腺素（thyroxine，T 4）、三碘甲状腺原氨酸（triiodothyronine，T 3）和促甲状腺激素（thyroid stimulating hormone，TSH），其中47对双胎早产儿之一符合TH诊断的早产儿作为TH组，双胎另一早产儿排除TH诊断作为对照组，2组分别为47例。采用Pearson相关性分析T 4与出生胎龄和出生体重的相关性，采用配对 t检验、Wilcoxon 符号秩和检验或McNemar检验，以及条件logistic回归分析双胎早产儿之一TH的影响因素。结果:47对双胎早产儿，共94例，出生胎龄为（31.4±2.3）周（26~36周），出生体重为（1 611.9±389.3）g（800~2 510 g）；异卵双胎35对，同卵双胎11对，1对同异卵情况不详。早产儿血清T 4水平与出生胎龄、出生体重均呈正相关（相关系数分别为0.209和0.376， P值均<0.05）。单因素分析结果显示，TH组与对照组比较 P<0.1的因素包括：女性［29.8%（14/47）与14.9%（7/47）， χ2=3.27］、合并支气管肺发育不良［31.9%（15/47）与19.1%（9/47）， χ2=3.13］、出生体重［（1 547.9±348.0）与（1 676.0±420.5）g， t=－3.61］、白细胞计数［（10.0±3.3）×10 9/L与（10.9±3.3）×10 9/ L， t=－2.19］、维生素D［（42.8±12.1）与（45.9±16.6）nmol/L， t=－1.76］。维生素D水平数据不完整，剔除该因素后logistic回归分析显示，女性为危险因素（ OR=18.388，95% CI：1.317~256.743），高出生体重为保护因素（ OR=0.996，95% CI：0.993~0.999）。为排除同卵双胎儿对性别因素的影响，剔除11对同卵双胎儿和1对同异卵情况不详病例后进行多因素分析，结果仍提示女性为危险因素（ OR=18.527，95% CI：1.209~283.820），高出生体重为保护因素（ OR=0.996，95% CI：0.992~1.000）。结论:女性和出生体重是生后11~20 d的双胎早产儿之一合并TH的影响因素。
其他摘要	Objective:To study the factors influencing transient hypothyroxinemia (TH) in one premature twin.Methods:This retrospective study enrolled 283 sets of preterm twins who were born at the gestational age of 26-36 weeks and admitted to the Neonatology Department of the Second Affiliated Hospital of Wenzhou Medical University from June 2009 to September 2021. The levels of thyroxine (T 4), triiodothyronine (T 3) and thyroid stimulating hormone (TSH) were detected at 11-20 d after birth. Finally, 47 sets of twins were further analyzed, in which one twin met the diagnostic criteria of TH (TH group, n=47) and the other twin with exclusion of the diagnosis (control group, n=47). Pearson correlation was used to analyze the correlation of T 4 with gestational age and birth weight. Paired t test, Wilcoxon signed-rank test or McNemar test, and conditional logistic regression were used to analyze the factors influencing TH in premature twins. Results:The gestational age and birth weight of the 47 sets of preterm twins (94 cases) were (31.4±2.3) weeks (26-36 weeks) and (1 611.9±389.3) g (800-2 510 g), respectively. There were 35 sets of dizygotic twins, 11 sets of monozygotic twins, and one set of twins with unknown zygosity. The serum T 4 level in premature infants was positively correlated with the gestational age and birth weight (the correlation coefficients were 0.209 and 0.376, respectively, both P<0.05). Univariate analysis showed that compared with the control group, the factors influencing TH in premature infants ( P<0.1) included female [29.8% (14/47) vs 14.9% (7/47), χ2=3.27 ], bronchopulmonary dysplasia [31.9% (15/47) vs 19.1% (9/47), χ2=3.13], birth weight [(1 547.9±348.0) vs (1 676.0±420.5) g, t=－3.61], white blood cell count [(10.0±3.3)×10 9/L vs (10.9±3.3)×10 9/L, t=－2.19] and vitamin D level [(42.8±12.1) vs (45.9±16.6) nmol/L, t=－1.76]. The data on vitamin D were incomplete and after excluding the factor, the logistic regression showed that female was a risk factor ( OR=18.388 95% CI: 1.317-256.743); while higher birth weight was a protective factor ( OR=0.996, 95% CI: 0.993-0.999). In order to exclude the influence of monozygotic twins on gender, 11 sets of monozygotic twins and one set with unknown zygosity were excluded from multivariate analysis. The results suggested that female was a risk factor ( OR=18.527, 95% CI: 1.209-283.820), while higher birth weight was a protective factor ( OR=0.996, 95% CI: 0.992-1.000). Conclusion:Female and birth weight are the factors influencing TH at 11-20 d after birth in one preterm twin.
资助项目	National Natural Science Foundation of China[82201902];Zhejiang Medical and Health Science and Technology Project[2023RC048];Wenzhou Science and Technology Planning Project[Y20180258,Y20210305];
ISSN	1007-9408
卷号	26 期号:10 页码:852-857
DOI	10.3760/cma.j.cn113903-20230817-00123
页数	6
收录类别	万方 ; SCOPUS ; 维普 ; CSCD ; ISTIC ; 北大核心
URL	查看原文
SCOPUSEID	2-s2.0-85176801475
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/206507
专题	附属第二医院附属第一医院_儿科
作者单位	1.温州医科大学附属第二医院育英儿童医院儿童重症医学科，温州　325000; 2.温州医科大学附属第一医院儿科，温州　325000
第一作者单位	附属第二医院
第一作者的第一单位	附属第二医院
推荐引用方式 GB/T 7714	林蓓蓓,缪克凡,林威. 双胎早产儿之一合并暂时性低甲状腺素血症的影响因素分析[J]. 中华围产医学杂志,2023,26(10):852-857.
APA	林蓓蓓, 缪克凡, & 林威. (2023). 双胎早产儿之一合并暂时性低甲状腺素血症的影响因素分析. 中华围产医学杂志, 26(10), 852-857.
MLA	林蓓蓓,et al."双胎早产儿之一合并暂时性低甲状腺素血症的影响因素分析".中华围产医学杂志 26.10(2023):852-857.