不同妊娠期妇女铁蛋白、血红蛋白与甲状腺激素水平的相关性

Correlations of serum ferritin,hemoglobin and thyroid hormones in different trimester pregnant women

目的探讨不同妊娠期妇女甲状腺激素、铁蛋白、血红蛋白(Hb)水平的变化及铁蛋白、Hb与甲状腺激素的相关性。方法选取561例首次行产前检查的孕妇,根据孕周分为妊娠早期组(200例)、妊娠中期组(180例)和妊娠晚期组(181例),以育龄期非孕健康女性180名作为正常对照组。分别检测血清甲状腺激素[三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)]、铁蛋白、Hb等指标,并进行统计分析。结果与正常对照组比较,妊娠期各组血清铁蛋白水平均显著降低(P<0.05);妊娠中、晚期组Hb水平显著降低(P<0.05),但妊娠早期组Hb水平与正常对照组比较差异无统计学意义(P>0.05)。铁蛋白及Hb水平均随孕期的增加而逐渐降低,妊娠早期与妊娠晚期比较差异有统计学意义(P<0.05)。Pearson相关分析结果显示,妊娠早期组Hb与FT3、FT4均呈正相关(r值分别为0.265、0.180,P值分别为0.000、0.004),妊娠晚期组Hb与FT3呈正相关(r=0.556,P=0.005);妊娠晚期组铁蛋白与FT3、FT4呈正相关(r值分别为0.502、0.494,P值分别为0.013,0.014)。结论孕妇铁蛋白及Hb水平随孕期FT3、FT4水平的降低而降低,其甲状腺功能改变可能与体内储存铁不足有关。

Objective To investigate the changes and the correlations of ferritin,hemoglobin(Hb)and thyroid hormones in different trimester pregnant women.Methods A total of 561 pregnant women at different trimesters receiving the first antenatal care were enrolled,and they were classified into 3 groups according to different trimesters,including the first trimester(200 cases),the second trimester(180 cases)and the third trimester(181 cases).Totally,180 healthy non-pregnant women were enrolled as control group.The levels of serum thyroid hormones,such as triiodothyronine(T3),thyroxine(T4),free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),were determined,and ferritin and Hb were determined as well.Statistical analysis was performed.Results Compared with control group,the levels of ferritin in the 3 groups were lower(P<0.05).The levels of Hb in the second trimester and the third trimester groups were lower(P<0.05),but there was no statistical significance between the first trimester and control groups(P>0.05).The levels of ferritin and Hb were decreased with the progress of pregnancy,and there was statistical significance between the first trimester and the third trimester groups(P<0.05).Pearson correlation analysis showed that Hb was positively correlated with FT3 and FT4 in the first trimester(r=0.265 and 0.180,P=0.000 and 0.004,respectively),and it was positively correlated with FT3 in the third trimester(r=0.556,P=0.005).Serum level of ferritin was correlated with FT3 and FT4 in the third trimester(r=0.502 and 0.494,P=0.013 and 0.014,respectively).Conclusions The decreasing of serum ferritin and Hb may lead to the low levels of FT3 and FT4.Thyroid dysfunction in pregnant women is closely related to iron deficiency.