妊娠期妇女血清铁蛋白与甲状腺激素的相关性研究

Correlation between serum ferritin and thyroid hormone in pregnant women

目的探究妊娠期妇女血清铁蛋白(SF)水平对其甲状腺激素的影响。方法用电化学发光法检测207例行孕期检查的健康单胎初产妇血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和SF,用热消解法检测孕妇尿碘浓度。结果纳入研究的207例妊娠早、中、晚期(T1、T2、T3期)孕妇尿碘中位数分别为191.15μg/L、198.60μg/L和229.40μg/L,组间比较差异无统计学意义(P>0.05)。随着孕龄的增长,孕妇SF、FT4均呈下降趋势(T1、T2、T3期SF中位数分别为63.01μg/L、55.28μg/L、15.40μg/L,FT4中位数分别为16.50 pmol/L、15.26 pmol/L、13.64 pmol/L),组间比较差异均有统计学意义(均P<0.05);FT3呈先升后降(T1、T2、T3期FT3中位数分别为4.48 pmol/L、5.06 pmol/L、4.67 pmol/L),组间比较差异有统计学意义(P<0.05);各孕期TSH(T1、T2、T3期TSH中位数分别为2.08 pmol/L、1.78 pmol/L、2.34 pmol/L)差异无统计学意义(P>0.05)。不同血清铁蛋白孕妇FT4水平组间比较差异有统计学意义(P<0.05)。结论妊娠期妇女FT4与其自身SF水平呈正相关关系,而且在碘营养适宜的情况下,孕妇储铁缺乏仍然可能会导致甲状腺功能减退,在积极倡导开展孕妇甲状腺功能和尿碘筛查外,建议加强孕期血清铁蛋白的监测。

Objective To explore the effect of serum ferritin(SF)level on thyroid function in pregnant women.Methods The serum levels of thyroid stimulating hormone(TSH),free three iodine thyroxine(FT3),free thyroxine(FT4)and SF were detected by electrochemiluminescence(ECL)in 207 healthy pregnant women with first baby,and the urine iodine concentrations in pregnant women were detected by heat digestion.Results The median urinary iodine of 207 pregnant women in the early,middle and late stages of pregnancy(T1,T2,T3)were 191.15,198.60 and 229.40μg/L,respectively.There was no significant difference among the three groups(P>0.05).With the increase of gestational age,the SF and FT4 of pregnant women showed decreasing trends(the median SF of T1,T2 and T3 were 63.01μg/L,55.28μg/L and 15.40μg/L,respectively,and the median of FT4 were 16.50 pmol/L,15.26 pmol/L and 13.64 pmol/L,respectively).The differences among the groups were statistically significant(P<0.05);FT3 increased first and then decreased(the median FT3 of T1,T2 and T3 were 4.48 pmol/L,5.06 pmol/L,4.67 pmol/L,respectively).The difference among the groups was statistically significant(P<0.05);the median TSH of T1,T2 and T3 were 2.08 pmol/L,1.78 pmol/L,2.34 pmol/L,there was no significant difference in the TSH levels among the three groups(P>0.05).There were significant differences in the levels of FT4 among the three groups of serum ferritin(P<0.05).Conclusion There is a positive correlation between SF and FT4 level in pregnancy.Moreover,under the condition of appropriate iodine nutrition,the deficiency of iron storage in pregnant women may lead to hypothyroidism.Therefore,in addition to actively advocating the development of maternal thyroid function and urine iodine screening,it is necessary to monitor serum ferritin level during pregnancy.