人绒毛膜促性腺激素与甲状腺功能关系的实验室和临床研究

An Experimental and Clinical Investigation on the Relationship between Human Chorionic Gonadotropin and Thyroid Function

采用细胞培养方法研究孕妇甲状腺刺激活性（ＴＳＡｂ）及人绒毛膜促性腺激素（ｈＣＧ）对甲状腺细胞环磷酸腺苷（ｃＡＭＰ）生成的调节作用。结果发现：①早孕组（孕８～１２周）及产前组（孕３４～３８周）血清促甲状腺激素（ＴＳＨ）水平明显降低，早孕组ＴＳＨ与血ｈＣＧ显著负相关。②早孕组及产前组血清ＩｇＧ的ＴＳＡｂ明显高于对照组，尤以早孕组为著，两组孕妇ＴＳＡｂ阳性率分别为７９％和５６％，ＴＳＡｂ与血ｈＣＧ、游离Ｔ３（ＦＴ３）、游离Ｔ４（ＦＴ４）正相关，与ＴＳＨ负相关。③在１０～１０５Ｕ／Ｌ的剂量区间，ｈＣＧ可显著刺激甲状腺细胞释放ｃＡＭＰ。提示孕妇ＴＳＡｂ来源于ｈＣＧ，后者是孕妇甲状腺功能生理调控及病理变化的重要介质。

Thyroid stimulating activity(TSAb) was measured using a highly sensitive bioassay on cAMP accumulation in cultured thyroid cells in comparison with the level of hCG in normal women in 21 early and 24 late pregnancy and 15 nonpregnant women. The direct effect of hCG on cAMP generation from cultured thyrocytes was also investigated. The results showed that: (1)Serum TSH level was significantly decreased both in early and late pregnancy as compared with normal controls. TSH level was statistically correlated with the serum hCG concentration in early pregnancy. (2)TSAb was detected in 15 of 19 and 10 of 18 cases in early and late pregnancy, respectively. None of 15 control subjects had TSAb detected.TSAb was positively correlated with the serum FT 3, FT 4and hCG levels and negatively with serum TSH concentration. (3) There was a dose dependent increase of cAMP secretion from cultured human thyrocytes in response to hCG(10 10 5U/L). The results indicate that in normal pregnancy, the thyroid gland is physiologically activated by serum hCG which has intrinsic thyroid stimulating activity and is an important TSH like factor for the regulation and alteration of thyroid function in pregnant women.