Changes Of Thyroid Hormone Levels In Preterm Infants With Intraventricular Hemorrhage And Intraventricular Hemorrhage

Objective:To investigate the correlation between different outcomes of intracranial hemorrhage and thyroid hormone level in premature infants through the comparative analysis of thyroid hormone levels in PIVH(periventricular-intraventricular hemorrhages)premature infants and non-PIVH premature infants at 1 week,2 weeks and 4 weeks after birth.Methods: Infants with the gestational age of 32-34 weeks admitted into the premature infant ward and NICU in our hospital from August 2015 to December 2016 were selected as the objects of study.Head color Doppler ultrasound examination was offered within 3d after birth.Infants were divided into PIVH group and non-PIVH group according to the presence of PIVH.PIVH group received the head color Doppler ultrasound examination at 2 weeks after birth and divided into the recovery group and non-recovery group according to the improvement of intracranial hemorrhage.According to whether PVL was accompanied in head MRI at 4 weeks after birth,infants were divided into PVL group and non-PVL group.Peripheral blood was drawn form all the subjects at 9:00 am at 1 week,2 weeks and 4 weeks after birth.Serum FT3,FT4 and TSH levels were measured via chemiluminescence,and the changes in FT3,FT4 and TSH levels were compared between different groups.Results1.Comparison of thyroid hormone level at 1 week after birth between PIVH group and non-PIVH group: The levels of FT3 and FT4 in PIVH group were lower than those in non-PIVH group,but TSH level was higher than that in non-PIVH group;and the differences were statistically significant(p<0.05).2.Comparison of thyroid hormone level at 1 week after birth between mild hemorrhage group and moderate-severe hemorrhage group in PIVH groupHemorrhage was divided into four degrees according to the Papile indexing method,among which I-II degrees were included in mild group and III-IV degrees were included in moderate-severe group.At 1 week after birth,there were 71 cases in mild group and 21 cases in moderate-severe group.The levels of FT3 and FT4 in moderate-severe group were lower than those in mild group,but TSH level was higher than that in mild group;and the differences were statistically significant(p<0.05).3.Comparison of thyroid hormone level at 2 weeks after birth between recovery group and non-recovery group.FT3 level in non-recovery group was lower than that in recovery group,but TSH level was higher than that in recovery group,and the differences were statistically significant(p<0.05).The difference in FT4 level was not statistically significant(p>0.05).4.Comparison of thyroid hormone level at 2 weeks after birth between PIVH group and non-PIVH group.FT3 level in PIVH group was lower than that in non-PIVH group,but TSH level was higher than that in non-PIVH group,and the differences were statistically significant(p<0.05).The difference in FT4 level was not statistically significant(p>0.05).5.Comparison of thyroid hormone level at 4 weeks after birth between PIVH group and non-PIVH group.There were no statistically significant differences in FT3,FT4 and TSH levels between PIVH group and non-PIVH group at 4 weeks after birth(p>0.05).6.Comparison of thyroid hormone level between PVL group and non-PVL group.There were 15 cases of PVL and 77 cases of non-PVL.FT3 and FT4 levels in PVL group were lower than those in non-PVL group,and the differences were statistically significant(p<0.05);TSH level was higher than that in non-PVL group,and the difference was statistically significant(p<0.05).7.Comparison of thyroid hormone level at 4 week after birth between PVL group and non-PVL group.FT3 and FT4 levels in PVL group at 4 week after birth were lower than those in non-PVL group(p<0.05);TSH level was higher than that in non-PVL group,and the difference was statistically significant(p<0.05).8.FT3 and FT4 levels in PVL group at 1 week after birth were lower than those in non-PVL group(p<0.05);TSH level was higher than that in non-PVL group,and the difference was statistically significant(p<0.05).Conclusions1.The thyroid function level in PIVH premature infants is decreased,mainly manifested in the decreased FT3 and FT4 levels and increased TSH level.With the improvement of illness,the thyroid function level gradually recovers.2.This study showed that the different outcomes of PIVH in premature infants,such as if hemorrhage is improved and if PVL is accompanied,are related to the low thyroid function level,suggesting that dynamic detection of thyroid hormone level in PIVH premature infants has a certain clinical significance for the prognosis determination and evaluation.