妊娠合并Graves病患者血清TSAb对甲状腺功能的影响

Changes of TSAb and thyroid function during pregnancy in patiences with Graves disease and it′s significance

目的观察妊娠合并Graves病患者在不同妊娠期及产后甲状腺功能(甲功)的变化,并探讨甲状腺刺激性抗体(TSAb)对甲功的影响。方法采用放射免疫法分别在妊娠早期(12周)、妊娠中期(24周)、妊娠晚期(34周)及分娩后12周测定妊娠合并Graves病患者的FT3、FT4、超敏促甲状腺激素(sTSH),ELISA法测定TSAb水平。结果妊娠中晚期TSAb、FT4、FT3、sTSH浓度低于妊娠早期(P均<0.05);复发者FT4、FT3、TSAb高于未复发者(P均<0.05)。在妊娠各时期及分娩后FT4与TSAb均呈正相关(r分别为0.57、0.62、0.53、0.78,P均<0.05)。结论随着妊娠进程的发展,妊娠合并Graves病患者TSAb、FT4降低,分娩后TSAb升高,且TSAb升高与甲亢复发有关。

Objective To investigate the change of thyroid function during different pregnancy in patiences with Gravesdisease and the effect of thyroid stimulating antibody（TSAb）on the thyroid function during pregnance and post partum.Methods The levels of FT3,FT4 and sTSH of pregnancy Gravesdisease patients were measured by radioimmunoassay respectively in early pregnancy（12 weeks）,mid-term pregnancy（24 weeks）,late pregnancy（34 weeks） and 12 weeks after childbirth.The level of TSAb was measured by ELISA methods.Results The levels of FT3,FT4,TSH and TSAb in mid-term pregnancy and late pregnancy were lower than those in early pregnancy（P0.05）.The levels of FT3,FT4 and TSAb were higher in relapse group than those in normal group（P0.05）.Correlation analysis confirmed that FT4 was negativly correlated with serum TSAb during pregnancy.Conclusions With the development of the process of pregnancy,the levels of TSAb and FT4 decrease,the level of TSAb increases after childbirth.The level of TSAb correlates with relapse hyper thyroidism.