重度子痫前期患者甲状腺激素水平与尿蛋白定量的关系研究  

Relationship between thyroid hormone level and urine protein quantitation in patients with severe preeclampsia

作　　者：程绍云[1] 曹锦鹏 牟晓峰 Cheng Shaoyun;Cao Jinpeng;Mou Xiaofeng(Department of Clinical Laboratory,the Third People's Hospital of Qingdao ,Qingdao ,Shandong ,266041,China;Department of Clinical Laboratory,Qingdao Central Hospital,Qingdao,Shandong 266042,China)

机构地区：[1]青岛市第三人民医院检验科,266041 [2]青岛市中心医院检验科,266042

出　　处：《中国基层医药》2019年第2期175-178,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的研究重度子痫前期患者甲状腺激素水平与24h尿蛋白定量的关系。方法选取青岛市第三人民医院和青岛市中心医院2015年8月至2017年10月收治的重度子痫前期患者180例,采用化学发光微粒免疫法测定促甲状腺激素(TSH)水平,按其检测结果分为两组:甲状腺正常组(110例,TSH为0.3~3.3mU/L)和甲状腺功能减退组(70例,TSH>3.3mU/L)。另选取同期于该院体检的240例健康孕妇为对照组,对比三组的TSH、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)水平和24h尿蛋白定量,分析重度子痫前期患者甲状腺激素水平与24h尿蛋白定量的关系,比较其甲状腺自身抗体结果。结果甲状腺正常组FT4、FT3的含量分别为(11.92±2.54)pmol/L、(5.22±1.25)pmol/L,甲状腺功能减退组FT4、FT3的含量分别为(9.02±1.09)pmol/L、(3.92±1.57)pmol/L,均低于对照组(t=6.657、16.758、13.221、18.245,均P<0.05),且甲状腺功能减退组低于甲状腺正常组(t=9.031、6.149,均P<0.05)。甲状腺正常组TSH和24h尿蛋白的含量为(2.56±0.86)mU/L、(66.51±18.52)mg,甲状腺功能减退组TSH和24h尿蛋白的含量为(5.87±3.02)mU/L、(79.14±12.58)mg,均高于对照组(t=2.330、7.197、16.417、13.335,均P<0.05),且甲状腺功能减退组高于甲状腺正常组(t=10.883、5.014,均P<0.05)。重度子痫前期患者的血清TSH与24h尿蛋白定量呈正相关(r=0.254,P=0.001),FT4与24h尿蛋白定量呈负相关(r=-0.182,P=0.025),而重度子痫前期患者的血清FT3与24h尿蛋白定量无相关性(r=-0.080,P=0.330)。甲状腺功能减退组患者TPOAb阳性率、TGAb阳性率分别为12.86%、18.57%,与甲状腺正常组的10.91%、14.55%比较差异无统计学意义(χ^2=0.158、0.513,P=0.691、0.474)。结论重度子痫前期患者甲状腺激素水平与24h尿蛋白定量存在相关性,通过检测其甲状腺激素水平,对于临床上治疗重度子痫前期患者具有较好的指导意义。Objective To study the relationship between thyroid hormone level and 24h urine protein quantitation in patients with severe preeclampsia. Methods From August 2015 to October 2017, 180 patients with severe preeclampsia who were treated in the Third People's Hospital of Qingdao were selected.The level of thyroid-stimulating hormone (TSH) was detected by chemiluminescence particles immune method.According to the test results, the patients were divided into normal group (n=110, TSH=0.3-3.3mU/L) and hypothyroidism group (n=70, TSH>3.3mU/L). Another 240 healthy pregnant women who admitted in the Third People's Hospital of Qingdao during the same period were selected as control group.The TSH, free triiodothyronine (FT3), free thyroxine (FT4) levels and 24h urine protein quantitation were compared among the three groups.The correlation between the level of thyroid hormone and 24h urine protein quantitation, the results of thyroid autoantibody in patients with severe preeclampsia were analyzed. Results The FT4, FT3 levels in the normal group were (11.92±2.54)pmol/L, (5.22±1.25)pmol/L, respectively, which in the hypothyroidism group were (9.02±1.09)pmol/L, (3.92±1.57)pmol/L, respectively, which were all lower than those in the control group (t=6.657, 16.758, 13.221, 18.245, all P<0.05), which in the hypothyroidism group were lower than those in the normal group (t=9.031, 6.149, all P<0.05). The TSH, 24h urine protein quantitation levels in the normal group were (2.56±0.86)mU/L, (66.51±18.52)mg, respectively, which in the hypothyroidism group were (5.87±3.02)mU/L, (79.14±12.58)mg, respectively, which were all higher than those in the control group(t=2.330, 7.197, 16.417, 13.335, all P<0.05), which in the hypothyroidism group were higher than those in the normal group (t=10.883, 5.014, all P<0.05). There was positive correlation between serum TSH and 24h urine protein quantitation in patients with severe preeclampsia (r=0.254, P=0.001). There was negative correlation between FT4 and 24h urine protein quantitation (r

关 键 词：先兆子痫 白蛋白尿 促甲状腺激素 游离三碘甲腺原氨酸 游离甲状腺素 甲状腺抗体 

分 类 号：R714.244[医药卫生—妇产科学]