全血微量元素与妊娠早期亚临床甲状腺功能减退关系研究

Analysis of the relationship between the determination of trace elements in blood and subclinical hypothyroidism in the first trimester of pregnancy

目的探讨孕妇全血7种微量元素的变化及其对孕早期亚临床甲状腺功能减退(甲减)的影响。方法选取2016年8月至2017年7月在潍坊市妇幼保健院围产保健门诊建档、孕周为4~12周、血细胞功能正常(非贫血)的孕妇240例,根据甲状腺功能分为亚临床甲减组(120例)与正常对照组(120例)。测定两组孕妇的甲状腺功能以及外周血7种微量元素铜、锌、钙、镁、铁、铅、镉的含量的变化情况并进行分析。结果妊娠早期亚临床甲减组锌、铁的水平[(85.43±3.39)μmol/L、(8.05±0.18)mmol/L)]高于正常对照组[(75.13±3.03)μmol/L、(7.23±0.13)mmol/L)],差异有统计学意义(P<0.05),其余5种微量元素铜、钙、镁、铅、镉的检测结果比较差异无统计学意义。亚临床甲减组全血锌的水平与血清促甲状腺激素呈正相关,差异有统计学意义(P<0.05)。结论妊娠早期微量元素的紊乱可能引起甲状腺功能的异常,对于孕早期处于亚临床甲减的孕妇不适于过多补充含锌和铁的制剂,以防亚临床甲减进一步发展为甲减。

Objective To explore the influence of the change about seven trace elements in peripheral blood on subclinical hypothyroidism in the first trimester of pregnancy.Methods From August 2016 to July 2017,total of 240 women with the first trimester of pregnancy（4~12 gestational weeks）without anemia in the care clinics of our hospital were selected and divided into two groups：subclinical hypothyroidism group（120 cases）and normal thyroid function group（120 cases）.Thyroid function and seven trace elements were detected,including Copper,zinc,calcium,magnesium,iron,lead and cadmium.Evaluated the impact of the different levels of the trace elements on subclinical hypothyroidism in the first trimester of pregnancy.Results Compared with normal thyroid function group（85.43±3.39）μmol/L,（8.05±0.18）mmol/L,the levels of zinc and iron of subclinical hypothyroidism（75.13±3.03）μmol/L,（7.23±0.13）mmol/L）was higher and the difference was statistically significant（P〈0.05）.The difference of the other five trace elements including copper,calcium,magnesium,lead and cadmium between the two groups were not statistically significant.The level of zinc was positively correlated with serum TSH in subclinical hypothyroidism group and the difference was statistically significant（P〈0.05）.Conclusion Disorder of trace elements in early pregnancy may lead to abnormal thyroid function.To prevent further development of subclinical hypothyroidism in hypothyroidism that will affect the fetal growth and development,early pregnancy in preparation for subclinical hypothyroidism of pregnant women is not suitable for too many supplements containing zinc and iron.