甲状腺上动脉峰值血流速度对妊娠合并甲状腺毒症的诊断意义探讨  

Discussion on the significance of peak systolic velocity of superior thyroid artery in diagnosis of thyrotoxicosis during pregnancy

作　　者：吴丹 辛慧 杨洋 岳巍 蔡凤 张丽丽 WU Dan;XIN Hui;YANG Yang(Department of Endocrinology and Metabolic Diseases,Third Affiliated Hospital of Shenyang Medical College(Shenyang 242 Hospital),Shenyang 110034,China)

机构地区：[1]沈阳医学院附属三院(沈阳二四二医院)内分泌与代谢病科,110034 [2]沈阳医学院附属三院(沈阳二四二医院)电诊科,110034

出　　处：《中国实用医药》2023年第3期87-90,共4页China Practical Medicine

基　　金：辽宁省科学技术计划项目(项目编号:2019-ZD-0875)。

摘　　要：目的分析甲状腺上动脉峰值血流速度(STA-PSV)对妊娠合并甲状腺毒症的诊断意义。方法选取88例妊娠合并甲状腺毒症孕妇作为研究组,包括妊娠合并毒性弥漫性甲状腺肿(Graves病)(GDP)患者62例(GDP组)和妊娠期一过性甲状腺毒症(GTT)患者26例(GTT组);另选取同期健康孕妇100例作为对照组。测定三组游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺激素(TSH)、促甲状腺激素受体抗体(TRAb)、STA-PSV水平。比较三组FT_(4)、FT_(3)、TSH水平和STA-PSV水平,GDP组和GTT组不同STA-PSV水平分布情况。结果GDP组孕妇的FT_(4)、FT_(3)、TSH分别为(38.40±4.34)pmol/L、(20.21±2.70)pmol/L、(0.03±0.01)mIU/L,GTT组分别为(27.67±3.77)pmol/L、(9.59±2.02)pmol/L、(0.06±0.02)mIU/L,对照组分别为(15.15±3.82)pmol/L、(5.22±2.76)pmol/L、(1.11±0.42)mIU/L;GDP组和GTT组孕妇的FT_(4)、FT_(3)水平均高于对照组,TSH水平低于对照组,差异具有统计学意义(P<0.05);GDP组孕妇的FT_(4)、FT_(3)水平均高于GTT组,TSH水平低于GTT组,差异具有统计学意义(P<0.05)。GDP组、GTT组孕妇的STA-PSV分别为(67.02±5.45)、(44.34±6.01)cm/s,均明显高于对照组的(29.62±3.22)cm/s,且GDP组孕妇的STA-PSV水平明显高于GTT组,差异具有统计学意义(P<0.05)。以STA-PSV≥56 cm/s为基准,GDP组中STA-PSV≥56 cm/s孕妇52例(83.9%),STA-PSV<56 cm/s孕妇10例(16.1%);GTT组中STA-PSV≥56 cm/s孕妇4例(15.4%),STA-PSV<56 cm/s孕妇22例(84.6%);GDP组STA-PSV≥56 cm/s孕妇占比高于GTT组,差异具有统计学意义(P<0.05)。结论STA-PSV水平可作为鉴别诊断GDP和GTT孕妇的重要依据。Objective To analyze the significance of peak systolic velocity of superior thyroid artery(STA-PSV)in diagnosis of thyrotoxicosis during pregnancy.Methods 88 women with thyrotoxicosis during pregnancy were selected as the research group,including 62 patients with toxic diffuse goiter(Graves’s disease)during pregnancy(GDP)(GDP group)and 26 patients with gestational transient thyrotoxicosis(GTT)(GTT group);another 100 healthy pregnant women at the same time were selected as the control group.The levels of free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),thyroid stimulating hormone(TSH),thyrotropin receptor antibody(TRAb),and STA-PSV were measured in each group.The FT_(4),FT_(3),TSH levels and STA-PSV levels in each group were compared,and the distribution of different STA-PSV levels in the GDP group and GTT group.Results The FT_(4),FT_(3),TSH of pregnant women in the GDP group were(38.40±4.34)pmol/L,(20.21±2.70)pmol/L,(0.03±0.01)mIU/L,respectively,while those in the GTT group were(27.67±3.77)pmol/L,(9.59±2.02)pmol/L,(0.06±0.02)mIU/L,and those in the control group were(15.15±3.82)pmol/L,(5.22±2.76)pmol/L,and(1.11±0.42)mIU/L,respectively.The FT_(4)and FT_(3)levels of pregnant women in both the GDP group and GTT group were higher than those in the control group,and the TSH levels were lower than those in the control group,and the differences were statistically significant(P<0.05).The FT_(4)and FT_(3)levels of pregnant women in the GDP group were higher than those in the GTT group,and the TSH levels were lower than those in the GTT group,and the differences were statistically significant(P<0.05).The STA-PSV of pregnant women in the GDP group and GTT group were(67.02±5.45)and(44.34±6.01)cm/s,which were significantly higher than(29.62±3.22)cm/s in the control group;the STA-PSV levels of pregnant women in the GDP group were significantly higher than those in the GTT group;the differences were statistically significant(P<0.05).Using STA-PSV≥56 cm/s as the baseline,there were 52 pregnant women(83.9%)with

关 键 词：妊娠合并甲状腺毒症 妊娠合并毒性弥漫性甲状腺肿 妊娠期一过性甲状腺毒症 甲状腺上动脉峰值血流速度 

分 类 号：R714.256[医药卫生—妇产科学]