早产儿促甲状腺素轻度增高与体格及神经心理发育关联性探讨

doi:10.20274/j.cnki.issn.2025.04.008

中国中西医结合儿科学 ›› 2025, Vol. 17 ›› Issue (4): 320-323.doi: 10.20274/j.cnki.issn.2025.04.008

早产儿促甲状腺素轻度增高与体格及神经心理发育关联性探讨

魏恩焕, 陈玮, 陈婉蓉, 邓云珍, 杨惠()

365001 福建三明，福建医科大学附属三明第一医院儿科

收稿日期:2025-03-18 修回日期:2025-06-10 出版日期:2025-08-25 上线日期:2025-08-25
通讯作者: 杨惠 E-mail:qzyh798@163.com
作者简介:魏恩焕（1974-），男，主任医师。研究方向：新生儿疾病的诊治
基金资助:
三明市科技计划项目（明科〔2022〕号2022-S-75）

Exploration of the correlation between mild elevation of thyroid-stimulating hormone and physical and neuropsychological development in preterm infants

Enhuan WEI, Wei CHEN, Wanrong CHEN, Yunzhen DENG, Hui YANG()

Affiliated Sanming First Hospital, Fujian Medical University, Sanming 365001, China

Received:2025-03-18 Revised:2025-06-10 Published:2025-08-25 Online:2025-08-25
Contact: Hui YANG E-mail:qzyh798@163.com
Supported by:
Sanming City Science and Technology Program Project(2022-S-75)

摘要/Abstract

摘要：

目的探讨生后2周内促甲状腺素（TSH）轻度增高与早产儿体格发育及神经心理发育关联性。方法选择2021年3月至2023年3月三明市第一医院收治的早产儿102例，其中轻度增高TSH血症早产儿52例为观察组，TSH正常早产儿50例为对照组。生后8 d检查振幅整合脑电图（aEEG），评价纠正年龄12月龄时体格发育，纠正年龄2周岁时神经心理发育水平的差异。神经心理发育评价采用儿童发育行为心理评定量表，发育商≥85分为正常。结果生后8 d aEEG监测显示，观察组睡眠-觉醒周期形成率为26.9%（14/52），低于对照组46.0%（23/50），差异有统计学意义（P<0.05）。两组在aEEG连续性指标及电压参数最高电压、最低电压方面比较差异无统计学意义（P>0.05）；纠正年龄12月龄体格发育评估观察组身高（71.7±2.1）cm，低于对照组(73.9±2.3)cm，差异有统计学意义（P<0.001），体质量及头围组间比较差异无统计学意义（P>0.05）。纠正年龄2周岁神经心理发育评估观察组精细动作、语言、社交行为发育商分别为（90.0±2.7）分，（89.0±2.7）分，（91.0±1.7）分，低于对照组（91.6±1.6）分，（90.0±1.6）分，（91.8±1.8）分，差异均有统计学意义（P<0.05）；大运动及适应能力发育商组间比较差异无统计学意义（P>0.05）。结论生后2周内早产TSH轻度增高与早产儿睡眠-觉醒周期形成、体格及神经心理发育有一定关联性，需要进行监测和管理。

关键词: 早产儿, 促甲状腺素, 神经心理, 体格, 发育

Abstract:

To investigate the association between mildly elevated thyroid-stimulating hormone (TSH) levels during the first two weeks of life and physical/neuropsychological development in preterm infants. Methods A total of 102 preterm infants admitted to Sanming First Hospital between March 2021 and March 2023 were enrolled. The cohort comprised 52 infants with mild TSH elevation (observation group) and 50 infants with normal TSH levels (control group). Amplitude-integrated electroencephalography (aEEG) was performed on postnatal day 8. The differences in physical development at corrected age (CA) of 12 months and neuropsychological development at CA of 24 months were evaluated. The neuropsychological development was assessed using the Child Development Behavior Psychological Scale, and developmental quotient ≥85 was defined as normal. Results The aEEG monitoring on postnatal day 8 revealed that formation of sleep-wake cycle in the observation group was 26.9%(14/52), lower than that of the control group(46.0%, 23/50)(P<0.05).No differences existed in aEEG continuity or voltage parameters (maximum/minimum voltage) between the two groups (P>0.05).At CA of 12 months, the observation group demonstrated significantly smaller body length than the control group [(71.7±2.1) cm vs. (73.9±2.3) cm; P<0.001], while body weight and head circumference showed no significant differences (P>0.05).At CA of 24 months, the development quotient(DQ) of the observation group was lower that that of the control group in fine motor (90.0±2.7 vs. 91.6±1.6), language (89.0±2.7 vs. 90.0±1.6), and social behavior (91.0±1.7 vs. 91.8±1.8) (P<0.05). The DQ in gross motor and adaptive abilities showed no statistical differences between the two groups (P>0.05). Conclusion Mildly elevated TSH levels in preterm infants within 2 weeks after birth are associated with the formation of sleep-wake cycles, physical growth, and neuropsychological development, necessitating monitoring and management.

Key words: Preterm infants, Thyroid-stimulating hormone, Neuropsychological, Physical, Development

中图分类号:

R722.6

魏恩焕, 陈玮, 陈婉蓉, 邓云珍, 杨惠. 早产儿促甲状腺素轻度增高与体格及神经心理发育关联性探讨[J]. 中国中西医结合儿科学, 2025, 17(4): 320-323.

Enhuan WEI, Wei CHEN, Wanrong CHEN, Yunzhen DENG, Hui YANG. Exploration of the correlation between mild elevation of thyroid-stimulating hormone and physical and neuropsychological development in preterm infants[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(4): 320-323.

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参考文献 16

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项目	观察组（n=52）	对照组（n=50）
胎龄（x±s，周）	32.15±2.16	32.36±1.98
出生体质量（x±s，ｇ）	1 892.12±236.25	1 899.26±251.32
身长（x±s，cm）	43.18±1.29	43.26±1.81
头围（x±s，cm）	30.56±2.21	30.76±2.50
女性	23(44.23)	21(42.00)
顺产	47(90.38)	46(92.00)
病情危重	41(78.85）	38(76.00）
合并症
新生儿感染	31(59.62)	32(64.00)
新生儿窒息	8(15.38)	7(14.00)
新生儿肺透明膜病	23(44.23)	21(42.00)
支气管肺发育不良	5(9.62)	4(8.00)
胆汁淤积症	4(7.69)	3(6.00)
新生儿坏死性小肠结肠炎	2(3.85)	1(2.00)

组别	n	连续性脑电图[n(%)]	睡眠-觉醒周期[n(%)]	高电压（x±s，μV）	低电压（x±s，μV）
对照组	50	18(36.0)	23(46.0)	13.5±2.6	5.3±1.4
观察组	52	22(42.3)	14(26.9)	12.9±2.2	5.5±1.1
χ²/t值		0.43	4.01	-1.28	0.80
P值		0.514	0.045	0.203	0.425

组别	n	身高（cm）	体质量（kg）	头围(cm)
对照组	50	73.9±2.3	9.3±1.3	45.2±1.5
观察组	52	71.7±2.1	9.2±1.2	44.6±1.6
t值		-5.04	-0.32	-1.95
P值		<0.001	0.750	0.052

组别	n	大运动	精细动作	适应能力	语言	社交行为
对照组	50	89.5±2.6	91.6±1.6	90.8±2.7	90.0±1.6	91.8±1.8
观察组	52	89.0±2.1	90.0±2.7	90.5±2.1	89.0±2.7	91.0±1.7
t值		-1.07	-3.66	-0.62	-2.29	-2.23
P值		0.285	0.004	0.536	0.024	0.023

早产儿促甲状腺素轻度增高与体格及神经心理发育关联性探讨

Exploration of the correlation between mild elevation of thyroid-stimulating hormone and physical and neuropsychological development in preterm infants

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