ÇOK DÜŞÜK DOĞUM AĞIRLIKLI YENİDOĞANLARDA KONJENİTAL HİPOTİROİDİ VE PREMATÜRE RETİNOPATİSİ İLİŞKİSİNİN ARAŞTIRILMASI
[ X ]
Tarih
2018
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Prematüreretinopatisi (PR), çocukluk çağında körlüğe neden olabilen başlıca prematürelerinretinasında meydana gelen vazoproliferatif bir hastalıktır. Çalışmamızda çokdüşük doğum ağırlıklı (ÇDDA) prematürelerde konjenital hipotiroidinin (KH)PR’si üzerine etkisi ve PR için risk faktörlerine bakılması amaçlanmıştır.Gereç ve Yöntem:Çalışma51 aylık dönem boyunca yatan ÇDDA bebeklerde geriye dönük tıbbi kayıtlarındeğerlendirilmesi neticesinde gerçekleştirildi. Hastalar KH tanısı ve lazerfotokoagülasyon tedavisi gerektiren PR olmasına göre gruplara ayrıldı.Bulgular: Çalışmaya 621 hasta dahil edildi. Bunlar arasında, 5.gün tiroid fonksiyon testi (TFT) sonucu olan, postnatal 1. ayda hem sağ kalanhem TFT sonucu olan hem de PR muayenesi yapılabilen 534 hasta ile çalışmasonlandırıldı. Konjenital hipotiroidi olan grupta (n=23) PR oranı %26,1 (n=6),KH olmayan grupta (n=511) PR oranı %10,9 (n=56) olarak tespit edildi.Konjenitalhipotiroidi olan ve olmayan gruplar arasında PR açısından anlamlı fark tespitedilmedi (p=0.077). Prematüre retinopatisi için risk faktörleri başlıca, düşükgebelik haftası, doğum ağırlığı, düşük 1. ve 5. dakika Apgar skoru, uzunmekanik ventilasyon ve oksijen destek süresi, respiratuvar distres sendromu,intraventriküler kanama, bronkopulmoner displazi, hemodinamik anlamlı patentduktus arteriosus ve geç neonatal sepsis olarak bulunmuştur. PR’i olan gruptaserbest tiroksin (sT4) düzeyi daha düşük, tiroid stimülan hormon (TSH) düzeyidaha yüksek bulunmuştur (sırasıyla, p=0.002; 0.047).Sonuç: KH’nin PR üzerine etkisi bulunmamıştır. Ancak,PR’si üzerine prematüreliğin getirdiği diğer riskler daha etkili bulunmuştur.PR’si olan infantlarda sT4 daha düşük, TSH daha yüksek bulunmuştur. Tiroidhormonlarının anjiyogenezis üzerine etkisi olduğundan, PR ve tiroid hormonlarıilişkisi açısından daha başka çalışmalara ihtiyaç vardır.
Objective: Retinopathy of prematurity (ROP) is avasoproliferative disease that mainly occurs in retinas of premature infants,and causes blindness in childhood. The aim of this study was to evaluate therisk factors for PR and the effect of congenital hypothyroidism (CH) on PR invery low birth weight infants (VLBW) (birth weight and lt;1500 g).Material and Method: The retrospective study wasconducted by the evaluation of medical records of hospitalized VLBW infantsduring the 51 months of follow-up. Patients were divided into groups accordingto diagnosed CH, and according to ROP requiring laser photocoagulation therapy.Results: There were 570 patients of 621 patientsof whom we were able to obtain TFT results on the 5th day of the study. A totalof 534 patients who survived the postnatal 1st month, and on whom wewere able to perform both TFT and ROP examinations were included in the study. The PR rate was 26.1%(n=6) in the groupwith congenital hypothyroidism (n=23) and the ROP rate was 10.9%(n=56) in thenon-CH group (n=511). However, there was no statistically significant differencebetween the groups in terms of ROP (p=0.077). The risk factors for prematureretinopathy were mainly including low gestational age/birth weight, low 1stand 5th minute Apgar score, longer duration of mechanicalventilation and oxygen support, respiratory distress syndrome, intraventricularhemorrhage, bronchopulmonary dysplasia, hemodynamically significant patentductus arteriosus and late neonatalsepsis. In infants with ROP, the levels offree thyroxine (sT4) were lower and the levels of thyroid stimulating hormone(TSH) were higher (p=0.002, 0.047, respectively).Conclusion: CH had no effect on ROP. However, otherrisks of prematurity on ROP were found to be more effective. In infants withROP, sT4 was lower and TSH was higher. Since thyroid hormones have an effect onangiogenesis, further studies on the relation between ROP and thyroid hormonesare warranted.
Objective: Retinopathy of prematurity (ROP) is avasoproliferative disease that mainly occurs in retinas of premature infants,and causes blindness in childhood. The aim of this study was to evaluate therisk factors for PR and the effect of congenital hypothyroidism (CH) on PR invery low birth weight infants (VLBW) (birth weight and lt;1500 g).Material and Method: The retrospective study wasconducted by the evaluation of medical records of hospitalized VLBW infantsduring the 51 months of follow-up. Patients were divided into groups accordingto diagnosed CH, and according to ROP requiring laser photocoagulation therapy.Results: There were 570 patients of 621 patientsof whom we were able to obtain TFT results on the 5th day of the study. A totalof 534 patients who survived the postnatal 1st month, and on whom wewere able to perform both TFT and ROP examinations were included in the study. The PR rate was 26.1%(n=6) in the groupwith congenital hypothyroidism (n=23) and the ROP rate was 10.9%(n=56) in thenon-CH group (n=511). However, there was no statistically significant differencebetween the groups in terms of ROP (p=0.077). The risk factors for prematureretinopathy were mainly including low gestational age/birth weight, low 1stand 5th minute Apgar score, longer duration of mechanicalventilation and oxygen support, respiratory distress syndrome, intraventricularhemorrhage, bronchopulmonary dysplasia, hemodynamically significant patentductus arteriosus and late neonatalsepsis. In infants with ROP, the levels offree thyroxine (sT4) were lower and the levels of thyroid stimulating hormone(TSH) were higher (p=0.002, 0.047, respectively).Conclusion: CH had no effect on ROP. However, otherrisks of prematurity on ROP were found to be more effective. In infants withROP, sT4 was lower and TSH was higher. Since thyroid hormones have an effect onangiogenesis, further studies on the relation between ROP and thyroid hormonesare warranted.
Açıklama
Anahtar Kelimeler
konjenital hipotiroidi, prematüre, prematüre retinopatisi, Çok düşük doğum ağırlığı, tiroid disfonksiyonu, Very low birth weight, congenital hypothyroidism, premature, retinopathy of prematurity, thyroid dysfunction, Health Care Administration
Kaynak
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
2
Sayı
3-232
