摘要
目的探讨妊娠合并甲状腺功能减退(甲减)患者血清同型半胱氨酸(Hcy)、维生素B_(12)(Vit B_(12))表达水平及其与母婴预后的相关性,为临床诊治及预测母婴结局提供参考依据。方法选取2015年1月-2017年1月中国人民解放军海军总医院收治的86例妊娠合并甲减孕妇为研究对象,其中妊娠合并亚临床甲减者49例,妊娠合并临床甲减者37例,同期选取40例甲状腺功能正常孕妇作为对照组,应用化学发光免疫分析法检测受试者甲状腺功能指标,利用全自动生化分析仪检测两组血糖、血脂指标,应用双抗体夹心酶联免疫法检测血清Hcy水平,采用放射免疫法检测血清Vit B_(12)水平,分析二者水平与母婴结局之间的相关性。结果妊娠合并甲减组促甲状腺激素(TSH)水平明显高于对照组,游离甲状腺素(FT_4)、游离三碘甲状腺原氨酸(FT_3)水平明显低于对照组,且妊娠合并临床甲减组TSH水平明显高于妊娠合并亚临床甲减组,FT_4、FT_3水平明显低于妊娠合并亚临床甲减组,差异有统计学意义(均P<0. 05)。妊娠合并甲减组存在血糖、血脂水平异常,且妊娠合并临床甲减组异常程度高于妊娠合并亚临床甲减组,差异有统计学意义(均P<0. 05)。妊娠合并甲减组Hcy水平明显高于对照组,Vit B_(12)水平明显低于对照组,且妊娠合并临床甲减组Hcy水平明显高于妊娠合并亚临床甲减组,Vit B_(12)水平明显低于妊娠合并亚临床甲减组,差异有统计学意义(均P<0. 05)。妊娠合并甲减组母婴不良结局总发生率明显高于对照组,差异有统计学意义(均P<0. 05)。妊娠合并甲减患者母婴不良结局组Hcy水平明显高于母婴正常结局组,Vit B_(12)水平明显低于母婴正常结局组,差异有统计学意义(均P<0. 05)。结论妊娠合并甲减患者血清Hcy明显高表达,Vit B_(12)明显低表达,推测二者对于母婴结局预测具有重要参考价值。
Objective To explore the expression levels of serum Hcy and vitamin B12 in patients with hypothyroidism in pregnancy and the relationships with maternal and infantile prognosis,provide a reference basis for clinical diagnosis,treatment,and prediction of maternal and infantile outcomes. Methods Eighty-six pregnant women with hypothyroidism treated in PLA Navy General Hospital from January 2015 to January 2017 were selected as study object,including 49 cases of subclinical hypothyroidism in pregnancy and 37 cases of clinical hypothyroidism in pregnancy. Forty pregnant women with normal thyroid function during the same period were selected as control group. Thyroid function indexes were detected by chemiluminescence immunoassay method,automatic biochemical analyzer was used to detect blood glucose and lipid indexes,and serum Hcy level was detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA) in the two groups. Serum vitamin B12 level was detected by radioimmunoassay method. The correlations between the levels of serum Hcy and vitamin B12 and maternal and infantile outcomes were analyzed. Results Thyroid stimulating hormone (TSH) level in hypothyroidism group was statistically significantly higher than that in control group (P<0. 05). The levels of free thyroxine (FT4) and free triiodothyronine (FT3) in hypothyroidism group were statistically significantly lower than those in control group (P<0. 05),TSH level in clinical hypothyroidism group was statistically significantly higher than that in subclinical hypothyroidism group (P<0. 05),FT4 and FT3 levels in clinical hypothyroidism group were statistically significantly lower than those in subclinical hypothyroidism group (P<0. 05). There were abnormal blood glucose and lipid levels in hypothyroidism group,and the abnormal degree in clinical hypothyroidism group was statistically significantly higher than that in subclinical hypothyroidism group (P < 0. 05). Hcy level in hypothyroidism group was statistically significantly higher than that in control group,serum vitamin B12 level in hypothyroidism group was significantly lower than that in control group (P<0. 05). Hcy level in clinical hypothyroidism group was statistically significantly higher than that in subclinical group (P<0. 05),serum vitamin B12 level in clinical hypothyroidism group was statistically significantly lower than that in subclinical hypothyroidism group (P<0. 05). The total incidence rate of adverse maternal and infantile outcomes in hypothyroidism group was statistically significantly higher than that in control group (P<0. 05). In hypothyroidism group,Hcy level in cases with adverse maternal and infantile outcomes was statistically significantly higher than that in cases with normal maternal and infantile outcomes (P<0. 05),serum vitamin B12 level was statistically significantly lower than that in cases with normal maternal and infantile outcomes (P<0. 05). Conclusion The expression of serum Hcy is high in patients with hypothyroidism in pregnancy,while the expression of serum vitamin B12 is low. It is concluded that Hcy and vitamin B12 have important reference value for prediction of maternal and infantile outcomes.
作者
谢明林
XIE Ming-Lin(Department of Obstetrics,PLA Navy General Hospital,Beijing,100048,China)
出处
《中国妇幼保健》
CAS
2019年第2期286-289,共4页
Maternal and Child Health Care of China
