摘要
目的探讨血清铁蛋白(SF)与妊娠期甲状腺功能减退的相关性。方法选取2017年1月至2018年6月在郑州大学第三附属医院行围产期保健的妇女,其中妊娠期甲减妇女165例(研究组),健康孕妇700例(对照组),比较两组的SF水平差异,分析SF与促甲状腺激素(TSH)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPOAb)水平的相关性。选取妊娠期临床甲减妇女59例,分析口服左甲状腺素钠片治疗前后SF水平。采用独立样本t检验、Mann-Whitney U检验、非参数Kruskal-Wallis检验、Spearman相关性分析进行统计学分析。结果健康妊娠妇女在孕早、中、晚期SF水平分别为54.00(22.75~69.50)mg/L、17.60(11.10~32.68)mg/L、11.20(8.70~20.80)mg/L,SF水平随孕周增加均呈下降趋势,三组间两两比较差异均有统计学意义(P<0.05)。妊娠期甲减妇女在早、中、晚孕期SF水平分别为14.10(8.88~35.95)mg/L、11.90(8.70~22.80)mg/L、8.75(6.63~15.88)mg/L,均低于对照组同孕期的SF水平,差异有统计学意义(P<0.05)。妊娠早期SF与血清FT4呈正相关(r=0.303,P=0.039);妊娠中期SF水平与血清FT4水平呈正相关(r=0.390,P=0.049)、与血清TSH水平呈负相关(r=-0.569,P=0.002)。妊娠期临床甲减妇女在左甲状腺素钠片治疗前后SF水平分别为8.90(6.53~10.50)mg/L、15.95(10.88~32.13)mg/L,差异有统计学意义(P<0.05)。结论妊娠期甲减妇女存在不同程度的SF水平的降低;SF水平与反映妊娠期甲状腺功能的指标(血清TSH、FT4、TPOAb水平)具有相关性;妊娠期甲减的妇女口服左甲状腺素钠片治疗后可提高SF水平,从而帮助有效治疗妊娠期并发症,改善母婴结局。
Objective:To investigate the correlation between serum ferritin and hypothyroidism during pregnancy.Methods:The number of pregnant women with hypothyroidism during pregnancy(Study Control),healthy pregnant women(Healthy Control)was 165 and 700,respectively.Their serum ferritin(SF)levels in each group were determined.The correlations between SF and thyroid-stimulating hormone(TSH),free thyroxine(FT4),and thyroid peroxidase antibody(TPOAb)were assessed.59 cases of hypothyroidism select women during pregnancy,SF levels analyzed before and after oral treatment of levothyroxine sodium tablets.Independent sample t test,Mann-Whitney U test,non-parametric Kruskal-Wallis test,Spearman correlation analysis were used for statistical analysis.Results:The SF levels of healthy pregnant women were 54.00(22.75~69.50)mg/L,17.60(11.10~32.68)mg/L,11.20(8.70~20.80)mg/L,which showed downward trend with the increase in gestational age,and there were differences between the three groups.All were statistically significant(P<0.05).The SF levels of women with hypothyroidism during pregnancy were 14.10(8.88~35.95)mg/L,11.90(8.70~22.80)mg/L,8.75(6.63~15.88)mg/L,all lower than the serum ferritin levels of the control group,the difference was statistically significant(P<0.05).SF in early pregnancy was positively correlated with serum FT4(r=0.303,P=0.039).SF levels in the second trimester was correlated with serum FT4.The level was positively correlated(r=0.390,P=0.049),and negatively correlated with the serum TSH level(r=-0.569,P=0.002).The serum ferritin levels of women withhypothyroidism during pregnancy treated with levothyroxine sodium tablets before and after treatment were 8.90(6.53~10.50)mg/L,15.95(10.88~32.13)mg/L,the difference was statistically significant(P<0.05).Conclusion:Women with hypothyroidism during pregnancy have different degrees of reduction in SF levels.SF levels are correlated with indicators of thyroid function during pregnancy(serum TSH,FT4,TPOAb levels).Oral levothyroxine sodium tablets can increase serum iron and ferritin levels in women with hypothyroidism during pregnancy and improve maternal and infant outcomes.
作者
潘瓷
史娜
谷存华
郭晓珮
岳巾晶
曾莹
罗晓华
Pan Ci;Shi Na;Gu Cunhua(Prenatal Diagnosis Center,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052;Department of Obstetrics and Gynecology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052)
出处
《现代妇产科进展》
CSCD
北大核心
2021年第12期887-890,共4页
Progress in Obstetrics and Gynecology
