重度子痫前期孕妇甲状腺功能变化及其与重度子痫前期发病的关系  

Thyroid hormone changes in women with pre-eclampsia and its relationship with the presence of preeclampsia

作　　者：周佳任[1] 杜鹃[1] 马冰[1] 刘学敏[1] 邱辉[1] 李洁[1] 王雪姣[1] 

机构地区：[1]中国医科大学附属盛京医院妇产科,沈阳110004

出　　处：《中华妇产科杂志》2014年第2期109-113,共5页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的 探讨重度子痫前期孕妇甲状腺激素水平变化、甲状腺疾病特点及其与重度子痫前期发病的关系.方法 选择2011年5月至2012年12月在中国医科大学附属盛京医院住院并分娩的重度子痫前期孕妇171例为重度子痫前期组,按发病孕周分为早发型114例和晚发型57例.随机抽取同期孕周和年龄与重度子痫前期组相匹配的血压正常、无产科合并症的健康孕妇171例为对照组.采用化学发光微粒免疫分析技术检测各组孕妇血清中促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）水平,采用化学发光法检测抗甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TGAb）水平,并计算其阳性率（TPOAb＞ 5.6 U/L为阳性,TGAb ＞4.1 U/L为阳性）.对重度子痫前期组孕妇血清TSH、FT3及FT4水平与血压的相关性进行分析.结果 （1）重度子痫前期组孕妇TSH中位水平为3.4 mU/L,FT4、FT3水平分别为（12.0±3.0）、（3.9 ±0.9） pmol/L;对照组分别为1.9 mU/L、（13.4±2.4）和（5.0±1.3） pmol/L,两组分别比较,差异均有统计学意义（P＜0.01）.其中早发型孕妇TSH中位水平为3.3 mU/L,FT4、FT3水平分别为（12.1±3.4）、（3.8±0.9）pmol/L;晚发型孕妇TSH中位水平为3.4 mU/L,FT4、FT3水平分别为（11.9±3.1）、（3.9±1.0）pmol/L,分别与对照组比较,差异有统计学意义（P＜0.01）；早发型与晚发型孕妇各指标分别比较,差异均无统计学意义（P＞0.05）.（2）重度子痫前期组孕妇TPOAb和TGAb阳性率分别为15.2％（26/171）和21.6％ （37/171）；对照组孕妇分别为12.3％ （21/171）和14.6％ （25/171）,两组孕妇TGAb阳性率比较,差异有统计学意义（P＜0.01）；TPOAb阳性率比较,差异无统计学意义（P＞0.05）.其中早发型孕妇TPOAb阳性率为12.3％ （14/114）,晚发型孕妇为21.1％ （12/57）,两者比较,差异无统计学意义（P＞0.05）；早发型孕妇TGAb�Objective To study thyroid hormone changes in women with pre-eclampsia patients,the characteristics of thyroid disease and its relationship with pre-eclampsia.Methods From May 2011 to December 2012 171 patients with pre-eclampsia who delivered in Shengjing Hospital of China Medical University were recruited as prc-eclampsia（PE） group,among which 114 cases were defined as early onset pre-eclampsia （EP） group and 57 cases were defined as late onset pre-eclampsia （LP） group.And 171 healthy women with same age and same stage of pregnancy were selected as the control group.Their blood pressures were normal and they had no obstetrical complications.Serum thyrotropin （TSH）,free triiodothyronine （FT3） and free thyroxine （FT4） levels were determined by solid-phase chemiluminescent enzyme immunoassay method （CMIA）.Thyroid peroxidase antibody （TPOAb） and thyroglobulin antibody （TGAb） were measured by electro-chemiluminescent assay （ECLIA）.The positive rate was calculated （TPOAb ＞ 5.6 U/L,TGAb ＞ 4.1 U/L were defined as positive result）.The relationship between TSH,FT3,FT4 level and blood pressure was analyzed in women with pre-eclampsia.Results （1） The median values of TSH,FT4 and FT3 in PE group were 3.4 mU/L,（12.0 ± 3.0） pmol/L and（3.9 ± 0.9） pmol/L.In the control group,they were 1.9 mU/L,（13.4 ± 2.4） and （5.0 ± 1.3） pmol/L.There were statistically significant differences between the two groups（P ＜ 0.01）.In EP group,the median values of TSH,FT4 and FT3 were 3.3 mU/L,（12.1 ± 3.4） pmol/L and （3.8 ± 0.9） pmol/L.The differences between EP group and the control group were statistically significant （P ＜ 0.01）.In LP group,the median values of TSH,FT4 and FT3 were 3.4 mU/L,（11.9 ± 3.1） pmol/L and （3.9 ± 1.0） pmol/L.There were statistically significant differences compared to the control group（P ＜0.01）.While there was no difference between EP group and LP group （P ＞ 0.05）.（2） The positive rate of TPOAb and TGAb in

关 键 词：先兆子痫 促甲状腺素 甲状腺激素类 自身抗体 

分 类 号：R714.245[医药卫生—妇产科学]