妊娠一过性甲状腺功能亢进与妊娠剧吐相关性研究  

A study of gestational transient thyrotoxicosis and hyperemisis gravidarum's correlation

作　　者：吕筱筠[1] 朱丽丽[1] 柏怡 石芳鑫[1] 

机构地区：[1]大连医科大学附属第一医院,大连116011

出　　处：《现代妇产科进展》2016年第6期411-414,共4页Progress in Obstetrics and Gynecology

基　　金：辽宁省科技计划项目神经系统疾病转化医学研究中心及协同研究网络建设(No:2013020197-219)

摘　　要：目的:通过观察妊娠剧吐患者孕期血清甲状腺功能及血清β-h CG水平,探讨妊娠剧吐合并一过性甲状腺功能亢进与血清β-h CG水平的相关性。方法:选取2008年1月至2013年12月因妊娠剧吐于大连医科大学附属第一医院产科住院治疗的129例孕妇,测定血清甲状腺功能,其中65例患者同时行血清β-h CG检测。分析患者血清甲状腺功能情况与β-h CG水平情况及两者相关性。根据患者孕周,分为A(5^(+1)~9周)、B(9^(+1)~12周)、C(12^(+1)~17^(+5)周)3组,分析各组甲状腺激素水平及β-h CG水平。结果:(1)129例妊娠剧吐患者的血清TSH、FT4、FT3水平中位数分别为0.446μIU/ml、19.17pmol/L、34.99pmol/L。A、B、C组患者血清TSH中位数为0.717μIU/ml、0.293μIU/ml和0.315μIU/ml;A组的血清TSH水平明显大于B、C组(P=0.043),但后两组间差异无统计学意义(P=0.086)。A、B、C组患者的血清β-h CG均数分别为(82465.56±45800.90)IU/L、(109338.00±52879.90)IU/L和(121179.67±43666.69)IU/L,3组间差异无统计学意义。(2)血清β-h CG与TSH两者之间存在显著负相关(r=-0.37,P<0.01);β-h CG与FT4之间存在显著正相关(r=0.404,P<0.01)。当妊娠剧吐患者血清β-h CG水平小于80000IU/L时,10.3%患者的血清TSH受到抑制;β-h CG为80 000~120 000IU/L时,47.4%血清TSH受到抑制;β-h CG大于120 000IU/L时,76.5%血清TSH受到抑制;差异有统计学意义(P=0.001)。结论:妊娠剧吐患者的血清β-h CG和TSH水平呈显著负相关,血清β-h CG和FT4水平呈显著正相关,当β-h CG水平大于120 000IU/L时,76.5%患者出现TSH水平抑制。Objective: To find out the correlation between β-h CG and GTT by observing the serum thyroid function and β-h CG levels in patients with hyperemesis gravidarum( HG). Methods: 129 cases of pregnant women with hyperemesis gravidarum in the First Affiliated Hospital of Dalian Medical University from Jan,2008 to Dec. 2013. Serum thyroid functions were tested. 65 cases of them also had serum β-h CG test. Serum thyroid function and β-h CG level were analyzed to explore the correlation between them. According to gestational weeks,129 patients were divided into three groups: A( 5^(+1)w ~ 9w) 、B( 9^(+1)w ~ 12w) 、C( 12^(+1)w ~ 17^(+5)w),thyroid hormones and β-h CG change patterns were analyzed. Results:( 1) Serum TSH、FT4、FT3 median level of 129 patients were 0. 446μIU / ml、19. 17 pmol / L、4. 99 pmol / L,respectively. TSH median levels of Group A、B、C were 0. 717μIU / ml,0. 293μIU / ml,0. 315μIU / ml,respectively. A> B( P = 0. 043),A > C( P < 0. 001),however the different between Group B and Group C has no statistical significance( P = 0. 086). Serum β-h CG mean level of Group A、B、Cwere( 82465. 56 ±45800. 90) IU / L,( 109338. 00 ±52879. 90) IU / L,( 121179. 67 ±43666. 69)IU / L,respectively,with no statistical significance.( 2) There was a negative correlation betweenβ-h CG and TSH( r =-0. 37,P<0. 01),meanwhile positive correlation between β-h CG and FT4( r=0. 404,P<0. 01). When HG patients' serum β-h CG was less than 80 000 IU/L,10. 3%patients' serum TSH were suppressed; β-h CG was 80 000 ~ 12 000 IU / L,47. 4% patients' serum TSH were suppressed; β-h CG was more than 12 000 IU / L,76. 5% patients' serum TSH were suppressed. Conclusion: There are negative correlation between serum β-h CG and TSH in HG patients,and positive correlation between β-h CG and FT4. When β-h CG is more than 120000 IU / L,76. 5% HG patients may develop GTT.

关 键 词：妊娠剧吐 妊娠期一过性甲状腺功能亢进 人绒毛膜促性腺激素 血清促甲状腺素 游离T4 

分 类 号：R714.256[医药卫生—妇产科学]