心脏导管对患有先天性心脏病的婴儿甲状腺功能的影响:一项前性观察性研究
Boshra A Elbaz1, Hala M Elmarsafawy2,3, Wafaa N Laimon4
1Department of Pediatrics, Neonatology Unit, Mansoura New General Hospital, Mansoura, Egypt.
European journal of pediatrics
|January 15, 2025
概括
心脏导管期间的化对比介质 (ICM) 和光镜持续时间是患有先天性心脏病的婴儿患甲状腺功能低下症的重要危险因素. 在手术后监测甲状腺功能至关重要,特别是对于高风险患者.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 内分泌学 在内分泌学.
- 放射学 放射学是一门学科.
背景情况:
- 过多的摄入可以暂时抑制甲状腺激素合成 (沃尔夫 - 柴科夫效应).
- 患有先天性心脏病 (CHD) 的婴儿由于甲状腺形态和对比介质暴露,对甲状腺功能低下的倾向更高.
研究的目的:
- 确定患有心脏病的婴儿心脏导管术 (CC) 后甲状腺功能低下的发病率,临床过程和危险因素.
- 确定与甲状腺功能低下相关的含对比剂 (iCM) 和光镜持续时间的特定值.
主要方法:
- 对115名患有心脏病的婴儿 (≤3岁) 进行CC的前性研究,与100名健康对照进行比较.
- 甲状腺功能测试 (TFT) 在CC之前进行,4周后,如果异常,则2周后进行.
- 分析了包括ICM剂量和光镜持续时间在内的风险因素.
主要成果:
- 甲状腺功能低下症在CC后4周的12%的婴儿中被检测到.
- 更高的ICM剂量 (RR=2.5) 和更长的光镜持续时间 (RR=2.12) 是显著的无变量预测因素.
- 多变量分析确定ICM剂量是唯一显著的预测因素 (RR=2.10);ICM的切断点为8.7gm/kg,光镜的切断点为24分钟.
结论:
- 在CC期间增加iCM剂量和延长光镜是患有心脏病的婴儿甲状腺功能低下症的危险因素.
- 建议在CC后4周对接受≥8.7g/kgICM或≥24分钟光镜的婴儿进行甲状腺特征评估.
相关概念视频
Synthesis and Regulation of Thyroid Hormones
4.2K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
4.2K
Functions of Thyroid Hormones
2.5K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
2.5K
Radiological Investigation I: X-ray and CT
206
Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and...
206
Cardiac Output I:Effect of Heart Rate on Cardiac Output
576
Cardiac Output
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
Effect of Heart Rate on Cardiac Output
Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart...
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
Effect of Heart Rate on Cardiac Output
Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart...
576
Imaging Studies for Cardiovascular System I:Echocardiography
293
Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
293
Imaging Studies for Cardiovascular System III: X-Ray
141
The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
141


