重度子痫前期患者甲状腺功能减退与24小时尿蛋白定量的相关性

Correlation between 24-hour urine protein and hypothyroidism in patients with severe pre-eclampsia

目的：研究重度子痫前期患者甲状腺功能减退与24 h尿蛋白定量及血清白蛋白的相关性。方法选择178例重度子痫前期患者，其中甲状腺功能减退组[促甲状腺激素（TSH）＞3.3 mU/L]69例，甲状腺功能正常组（TSH 0.3～3.3 mU/L）109例。随机抽取同期孕周和年龄与之相匹配的血压正常、无产科合并症的健康孕妇268例为对照组。检测所有孕妇甲状腺激素水平和血清白蛋白及重度子痫前期孕妇的24 h尿蛋白定量，分析指标间相关性。结果甲状腺功能减退组及甲状腺功能正常组FT3、FT4均显著低于对照组（ P＜0.01）。甲状腺功能减退组24 h尿蛋白定量显著高于甲状腺功能正常组（ P＜0.01）。早发型子痫前期组24 h尿蛋白显著高于晚发型组（P＜0.05）。重度子痫前期患者中TSH和24 h尿蛋白定量呈正相关（r＝0.26 P＝0.001），与血清白蛋白呈负相关（r＝-0.23，P＝0.002）；FT4与24 h尿蛋白定量呈负相关（r＝-0.17，P＝0.023），与血清白蛋白呈正相关（r＝0.22 P＝0.003）；FT3与24 h尿蛋白定量无相关性（r＝-0.07，P＝0.340），与血清白蛋白呈正相关（r＝0.35，P＝0.000）。结论重度子痫前期患者甲状腺功能减退对24 h尿蛋白定量有影响，发生甲状腺功能减退患者的24 h尿蛋白定量显著大于未发生甲状腺功能减退者，甲状腺激素水平与24 h尿蛋白定量有相关性。重度子痫前期患者甲状腺激素水平可以作为其严重肾功能损伤的监测指标。

Objective To study correlation between 24-hour urine protein and hypothyroidism in patients with severe pre-eclampsia.Methods A total of 178 patients with severe pre -eclampsia （S-PE）, among which 69 cases （ TSH〉3.3 mU/L） were served as hypothyroidism group and 109 S-PE cases with normal TSH （ TSH 0.3-3.3 mU/L） were selected as normal group , were included;while 268 healthy women with matched pregnancy stage and age with nor-mal blood pressures and no obstetrics complications were selected as controls .Thyroid hormones （ TSH, FT3 and FT4 ） and serum albumin were measured , and so was the 24-hour urine protein in patients with S -PE.Results The FT3 and FT4 in hypothyroidism group and normal group were significantly lower than control group （ P〈0.01 ） .Significantly higher 24-hour urine protein was observed in hypothyroidism group than normal group （P〈0.01）.Moreover, there was signifi-cantly higher 24-hour urine protein in early -onset preeclampsia （ EOP） than late-onset preeclampsia （ LOP） patients （P〈0.05）.In the S-PE group, TSH was significantly positively correlated with 24-hour urine protein （r=0.26, P=0.001）, and negatively correlated with serum albumin （r=-0.23, P=0.002）; and FT4 was significantly negatively correlated with 24-hour urine protein （r=-0.17, P=0.023）, and positively correlated with serum albumin （r=0.22, P=0.003）.There was no significant correlation between FT 3 and 24 -hour urine protein （ r =-0.07, P=0.340）.There was significantly positive correlation between FT 3 and serum albumin （r=0.35, P=0.000）.Conclusion Hypothyroidism in patients with S -PE elevates the 24-hour urine protein , which is correlated with the severity of hy-pothyroidism .Thyroid hormone levels in patients with pre -eclampsia can be applied as monitoring indicators for renal function.