妊娠期甲亢患者血清甲状腺功能和免疫含量变化的临床价值  

Clinical significance of the changed serum thyroid function and immune content from patients with gestational hyperthyroidism

作　　者：马聪 

机构地区：[1]温岭市妇幼保健院妇产科,浙江省温岭317500

出　　处：《中国医师杂志》2014年第3期356-357,360,共3页Journal of Chinese Physician

摘　　要：目的 探究分析妊娠期甲亢患者血清甲状腺功能和免疫含量变化的临床价值.方法 选取本院自2008年10月至2012年10月期间收治的妊娠期甲亢患者若干例,作为临床研究对象.选取分娩后复发甲亢患者作为73例作为试验组；选取分娩后未复发甲亢患者73例作为对照组.测量两组患者妊娠各时期甲状腺功能和TSH受体刺激抗体（TSAb）浓度,记录并比较两组患者分娩后甲状腺功能和TSAb浓度.结果 两组患者妊娠中期、晚期游离三碘甲状腺原氨酸（FT3）、游离四碘甲状腺原氨酸（FT4）、TSAb浓度较妊娠早期均明显降低,超敏促甲状腺激素（HS-TSH）浓度则逐渐增高,且试验组患者分娩后FT3、FT4及TSAb浓度[（11.72±5.43） pmol/L、（42.30±6.25）pmoL/L、（34.17±6.39）IU/L]均明显高于对照组[（5.34±2.01）pmoL/L、（22.31 ±5.74） pmol/L、（24.72 ±4.78） IU/L],差异具有统计学意义（P＜0.05）.结论 妊娠期甲亢患者在妊娠过程中,随着妊娠进程的发展,其FT3、FT4、TSAb浓度均不同程度降低,且分娩后甲亢复发患者TSAb浓度明显高于未复发患者,提示TSAb浓度升高与甲亢复发有关.Objective To explore the clinical value of changes of serum thyroid function and immune content from patients with gestational hyperthyroidism. Methods A total of 146 eases of patients with hyperthyroidism during pregnancy and 73 cases of pa- tients with recurrence of hyperthyroidism after delivery were chosen as the experimental group, and 73 cases of patients without recur- rence of hyperthyroidism after delivery were chosen as the control group. The thyroid function and thyroid-stimulating antibody （TSAb） concentrations at different period of pregnancy for two groups were tested. The thyroid function and TSAb concentrations after pregnancy of the two groups were also tested. Results At the mid and late period of pregnancy, the concentrations of free triiodothyronine （FT3） and free tetraiodothyronine （FT4） were significantly lower than early pregnancy. The concentrations of hypersensitive thyroid stimulating hormone （sTSH） and TSAb were increased gradually. The concentrations of FT3, FT4, and TSAb after pregnancy were all significandy higher than control group （ P 〈 0. 05）. Conclusions FT3, FT4, sTSH, and TSAb can be used for early diagnosis of hyperthyroidism during pregnancy, and have a certain predictive value for relapse after secretion.

关 键 词：甲状腺功能亢进症 免疫学 妊娠并发症 受体 促甲状腺素 血液 

分 类 号：R714.256[医药卫生—妇产科学]