新生儿脐血及不同孕期妇女血液中甲状腺激素综合测定在妇幼保健中的作用

Studies on the Usefulness in Maternal and Children Health Care of Comprehensive Measurement of Blood Thyroid Hormones Levels in Neonatal Cord and Pregnant Women of Different Trimesters

目的 :探讨我区正常孕妇妊娠期间及新生儿血液中的甲状腺激素的水平和碘缺乏状态 ,为我区消灭新生儿碘缺乏症提供依据。方法 :利用放射免疫(或免疫放射)分析方法 ,对沂蒙山区300例正常孕妇不同孕期血液和2000例新生儿脐血中TT3、TT4、FT3、FT4、rT3、TSH进行综合检测和相关性研究。结果 :孕妇血清中TT3、TT4、FT3、FT4、rT3、TSH值均发生变化 ,以TT3、TT4、rT3、TSH变化较为显著(与孕前比较p<0.05或p<0.01),FT3、FT4 二者在妊娠期间变化较小 ,其值均在正常范围内。男女两性新生儿脐血中的甲状腺激素和促甲状腺激素无显著性差异 ,山区居民新生儿脐血中TT3、TT4、FT3、FT4、rT3 均低于、TSH高于城镇居民新生儿 ,TT3、TT4 之间存在显著性差异 (p<0.05);有6例(0.30 %)新生儿存在缺碘状况。山区居民孕妇血清中的甲状腺激素普遍较城镇居民偏低 ,未发现碘营养缺乏者。结论 :检测孕妇血清和新生儿脐血中FT3、FT4、TSH ,是判断孕妇、胎儿及新生儿是否存在碘缺乏重要依据。在孕期、婴幼儿期及时给予补碘治疗能有效地改善胎儿和新生儿缺碘状况。

Objective To investigate the blood thyroid hormones levels in normal pregnant women and neonatels with the purpose of therapeutic elimination of hypo-iodism in neonates of our region.Method Blood TT3, TT4, FT3,FT4,rT3 and TSH levels were determined with RIA (or IRMA) and correlatively studied in 300 pregnant women and 2000 neonates (using cord blood all those subjects were from the local Yimeng region).Results In pregnant women, the serum TT3, TT4, rT3 and TSH levels were found to be higher than the pre-pregnant levels (P<0.01-0.05), however, FT3 and FT4 were not much changed. No sex difference in cord blood hormone levels existed. In mountainous area, the neonatal cord blood TT3, TT4, FT3, FT4 and rT3 levels were lower but TSH levels were higher than those in neonates of town areas, P values for TT3 and TT4 were significant (P<0.05). Six neonates (0.3%) were found to be in bypo-iodism status (very low TT3 and TT4 and high TSH). Blood thyroid hormones levels in pregnant women of mountainous area were usually lower than those in town people but not to the degree of hypoiodism.Conclusion Determination of blood FT3, FT4 and TSH levels in pregnant women and neonates is very important for understanding the iodine metabolism status and furnishing replenishment if necessary.