孕妇服用丙硫氧嘧啶对胎儿血药浓度及甲状腺的影响

THEEFFECTSOFPROPYLTHIOURACILONTHEFETALTHYROIDANDSERUMCONCENTRA┐TIONINPREGNANTWOMEN

为了解孕妇服用丙硫氧嘧啶（ＰＴＵ）后胎儿血药浓度及对胎儿甲状腺的影响，应用高效液相色谱法，对９例必须行中期引产的妇女顿服不同剂量（５０ｍｇ、１００ｍｇ及１５０ｍｇ）ＰＴＵ后，进行了孕妇末梢血、胎心血和胎儿甲状腺组织中ＰＴＵ浓度测定，并用组化染色法测定了胎儿甲状腺过氧化物酶（ＴＰＯ）的活性。结果表明，ＰＴＵ可迅速通过胎盘，并在胎儿甲状腺中高度聚集，胎儿血ＰＴＵ浓度与孕妇同期血ＰＴＵ浓度呈正相关。在孕妇血ＰＴＵ浓度达最大治疗效果的最低药物浓度（４ｍｇ／Ｌ）时，ＰＴＵ对胎儿甲状腺组织的ＴＰＯ活性无影响。结果提示：顿服ＰＴＵ在１５０ｍｇ及１５０ｍｇ以下剂量，对绝大多数孕妇可能是安全的。进一步的影响还有待深入研究。

Inordertostudytheefectsofpropylthiouracil(PTU)onthefetalthyroidandserumconcentration,9womenundergoingtherapeuticabortionatthesecondtrimesterofpregnancyweregivenasingledoseof50,100and150mgPTUrespectively.TheconcentrationsofPTUinthematernalandfe-talserumandthoseinthefetalthyroidtissuesweredeterminedwithahigh-performanceliquidchro-matographicmethod,thelowestlimitofwhichwas25μg/L.AfteranoralbolusofPTU,thePTUcon-centrationsinthematernalserumreachedapeaklevelafteronehourandtherewasawideindividualvariationofthepeakvalue.ThestudyshowedPTUcouldbetransferredthroughtheplacentafromthematernalbloodtothefetalbloodandhighlyacumulatedinthefetalthyroidtissues.ThefetalserumPTUconcentrationscorelatedwiththoseoftheirmothersatthesametime(r=0.7084,P<0.02)andtheconcentrationsinthefetalthyroidtissuescouldbeevaluatedbythematernalserumpeaklevelafteranoralbolus.PTUdidn′tinhibitthefetalthyroidperoxidaseactivityevenwhenthematernalserumPTUconcentrationreached4mg/L,whichisthelowestefectivetherapeuticconcentrationofPTUinadults.