Graves’病放射碘治疗后甲状腺功能减退产妇乳汁和血与婴儿血甲状腺激素水平  

Clinical Observation of Thyroid Hormone Levels of Babies and Mothers after Treatment of GD with ^(131)Ⅰ

作　　者：李妮[1] 廖柯华[2] 卢桂南[2] 陈翠玲[2] 谢建南[2] 黄莹[2] 黄敏葵[2] 

机构地区：[1]广西壮族自治区人民医院内分泌科,广西南宁530021 [2]广西壮族自治区人民医院核医学科实验室,广西南宁530021

出　　处：《中国慢性病预防与控制》2009年第6期575-576,共2页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的观察Graves'病服^(131)碘(^(131)I)后甲状腺功能减退(简称甲减)产妇乳汁和血及婴儿血甲状腺激素的水平。方法采用直接化学发光技术的竞争免疫测定法对Graves'病^(131)I治疗后36名出现甲减产妇(其中治愈产妇组20人,甲减产妇组16人)和正常产妇20人(正常产妇组)血、乳及婴儿的血游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)、促甲状腺素(S-TSH)指标定量检测。结果甲减产妇组血FT_3、FT_4分别为(3.38±0.58)pmol/L、(7.12±1.06)pmol/L,乳汁FT_3、FT_4分别为(1.49±0.48)pmol/L、(3.09±0.73)pmol/L,血和乳汁S-TSH分别为(106.25±29.74)、(2.20±0.31)uIU/ml与正常产妇和治愈产妇组比较,差别均有统计学意义(P<0.01)。治愈产妇组和正常产妇组乳FT_3水平占血FT_3的50%以上,而甲减产妇组为39%。相关分析显示,正常产妇组乳FT_3与血FT_3、乳FT_4与血FT_4呈正相关(r=分别为0.77,0.87,P<0.01)。甲减产妇组乳FT_4与血FT_4呈正相关(r=0.99,P<0.01)。甲减组婴儿TSH[(6.24±0.75)uIU/ml]与正常和治愈组婴儿组比较,差别有统计学意义(P<0.01)。甲减组产妇血FT_4与婴儿血FT_4、产妇血TSH与婴儿血TSH呈正相关(分别r=0.83、0.73,P<0.Objective To observe the thyroid hormone （TH） levels in blood of the infants and in blood and breast milk of the mothers with hypothyroidism after taking I131 treatment for their Gravers disease （GD）. Methods Free triiodothyronine （FT3）, free thyroxin（FT4）, sensitive thyrotropin（sTSH） were measured in 36 lying-in women with hypothyroidism after I131 treatment for their GD （16 subjects with hypothyroidism and 20 cured subjects after treatment with TH） and 20 normal lying-in women and their babies. Results In lying-in women with hypothyroidism due to 131I treatment, levels of sTSH, FT4 and FT3 in blood and milk were significantly lower than those in healthy and cured subjects （P〈0.01）. The quantity of FT3 in milk of healthy and cured lying-in women was more than 50% to their blood; however the quantity of FT3 in milk of hypothyroidism women was 39% to their blood. In the healthy group, both of the quantities of FT3 and FT4 in milk and blood were in direct proportion（r=0.77 and 0.87, P〈0.01）. In the hypothyroidism group, the quantity of FT4 in milk and blood was direct proportion （r=0.99, P〈0.01）. TSH in hypothyroidism babies（6.24±0.75 ） ulU/ml was significantly higher than that in babies of healthy and cured groups （P〈0.01）. FT4, TSH in blood of lying-in women with hypothyroidism and in blood of their babies were in direct relation（r=0.83 and 0.73, P〈0.05）. Conclusion The babies of lying-in women with hypothyroidism need more TH; TH treatment for maternal hypothyroidism can not be stopped during pregnant and lactation periods.

关 键 词：Graves’病 碘治疗 甲状腺功能减退症 母乳 甲状腺激素 

分 类 号：R589[医药卫生—内分泌]