妊娠早期、中期、晚期甲状腺功能与HCG、雌孕激素相关性

The correlation between thyroid function and HCG,estrogen and progesterone in the early,middle,and late stages of pregnancy

目的探讨妊娠早期、中期、晚期甲状腺功能与HCG、雌孕激素相关性。方法选取2016年6月至2017年6月来本院进行常规孕前检查的90例妊娠期孕妇进行研究,按照妊娠时期的不同,分为妊娠早期、妊娠中期和妊娠晚期三组,每组有30人。分别检测三组孕妇的促性腺激素(HCG)、促甲状腺激素(TSH)、孕酮(PROG)、雌二醇(E2)、游离雌三醇(uE3)和甲胎蛋白(AFP),并对这些指标进行比较分析,同时对三组孕妇的甲状腺激素水平进行比较分析。结果妊娠早期和妊娠中期孕妇相比,HCG和TSH水平差异无统计学意义(P>0.05);妊娠晚期孕妇同妊娠早期和妊娠中期孕妇相比,HCG水平明显下降,TSH水平明显增高,比较差异有统计学意义(P<0.05)。不同孕期的孕妇发生甲状腺功能紊乱的总发生率分别为10%、20%、16.67%,三组孕妇甲状腺功能紊乱总发生率比较差异无统计学意义(χ^2=1.184,P=0.553)。PROG、E2、uE3和AFP在妊娠过程中均呈现出逐渐上升趋势,在妊娠中期显著高于妊娠早期,比较差异有统计学意义(P<0.05),在妊娠晚期均显著高于妊娠早期和妊娠中期,比较差异有统计学意义(P<0.05)。结论甲状腺功能在不同的妊娠阶段有着不同的表达,促性腺激素水平会随着妊娠周期的增加而降低,促甲状腺激素水平则随着妊娠周期的增加而升高,两者之间呈负相关,孕妇血清中PROG、E2、uE3和AFP也呈现上升趋势。HCG对垂体-甲状腺轴可能存在一定的影响,其可用于监测甲状腺功能,对预防和改善妊娠结局也提供一定的参考,临床应用价值较高。

Objective To explore the relationship between thyroid function and HCG,estrogen and progesterone in the early,middle,and late stages of pregnancy.Methods 90 pregnant women in our hospital from June 2016 to June 2017 were selected for routine pre pregnancy examination.According to the different pregnancy periods,they were divided into three groups:early pregnancy,mid pregnancy,and late pregnancy,30 cases in each group.Gonadotropin(HCG),thyroid stimulating hormone(TSH),progesterone(PROG),estradiol(E2),uncojugated estriol(uE3),and alpha fetoprotein(AFP)were detected in three groups of pregnant women,and these indexes were analyzed at the same time,the thyroid hormone level of the three groups of pregnant women were compared.Results There were no statistically significant differences in HCG and TSH levels between the first trimester and the second trimester(P>0.05).Compared with pregnant women in the first and second trimester of pregnancy,HCG level in pregnant women in the third trimester of pregnancy was significantly decreased,and TSH level was significantly higher,with statistically significant differences(P<0.05).The incidence of thyroid dysfunction was 10%,20%,and 16.67%in pregnant women in the first,second,and third trimester of pregnancy respectively.The total incidence of thyroid dysfunction in the three groups was not statistically significantly different(χ^2=1.184,P=0.553).PROG,E2,uE3,and AFP showed a gradual upward trend during pregnancy,which was significantly higher in the second trimester than those in the first trimester(P<0.05),and which was significantly higher in the third trimester than those in the first and second trimester of pregnancy(P<0.05).Conclusions Thyroid function has different expressions in different stages of pregnancy.Gonadotropin level decreases with the increase of pregnant weeks,and thyroid stimulating hormone level increases with the increase of pregnant weeks,there is a negative correlation between them.Maternal serum PROG,E2,uE3,and AFP also show an upward trend.HCG may have an effect on pituitary thyroid axis,which can be used to monitor thyroid function,and provide reference for preventing and improving pregnancy outcomes,with high clinical application value.