不同孕期女性血清中人绒毛膜促性腺激素与促甲状腺激素水平相关性分析

Correlation analysis of human chorionic gonadotropin and thyroid-stimulating hormone in serum of women with different pregnancy periods

目的研究不同孕期女性人绒毛膜促性腺激素(HCG)和促甲状腺激素(TSH)的相关性。方法本研究随机选取2018年10月至2020年6月杭州市妇产科医院产科门诊就诊的150例妊娠期女性作为研究对象,根据妊娠期不同,分为妊娠早、中、晚期各50例,对比三组孕妇HCG、TSH、游离甲状腺素(FT4)的水平、分析不同孕期HCG、TSH和FT4的相关性、比较不同孕期甲减发生率。结果妊娠晚期女性TSH水平最高,其次是妊娠中期和早期,妊娠晚期女性HCG和FT4水平最低,其次是妊娠中期和早期,组间比较差异有统计学意义(P<0.05)。不同妊娠期甲减发生率为2.0%~6.0%,组间比较,差异无统计学意义(P>0.05)。经Pearson相关性分析显示,妊娠晚期孕妇HCG水平均与FT4水平呈正相关(r=0.311,P=0.028),不同妊娠期孕妇HCG水平均与TSH水平呈负相关(r=-0.103,P=0.048;r=-0.111,P=0.044;r=-0.149,P=0.030)。结论随着妊娠周期的增加,HCG水平逐渐降低,而TSH水平持续升高,FT4分泌减少,可能会增加甲状腺功能发生紊乱的风险。因HCG可对垂体-甲状腺轴产生一定影响,故可根据HCG变化水平定期检查甲状腺功能,从而有效预防或改善不良妊娠结局,以确保孕妇及胎儿健康,对临床合理干预具有较高价值。

Objective To study the correlation between human chorionic gonadotropin(HCG)and thyroid stimulating hormone(TSH)in women with different pregnancy periods.Methods This study randomly selected 150 pregnant women who came to Hangzhou Obstetrics and Gynecology Hospital Obstetrics Clinic from October 2018 to June 2020 as the research objects.According to the different pregnancy periods,they were divided into early,middle,and late pregnancy groups,with 50 cases in each group.The levels of HCG,TSH,and free thyroxine(FT4)in the three groups of pregnant women were compared.The correlation between HCG,TSH,and FT4 in different pregnancy periods was analyzed.The incidence of hypothyroidism in different pregnancy periods was compared.Results The TSH level of women in the late pregnancy group was the highest,followed by the middle and early pregnancy.The HCG and FT4 levels of women in the late pregnancy were the lowest,followed by the middle and early pregnancy.There were statistical differences between the groups(P<0.05).The incidence of hypothyroidism in different pregnancy periods was about 2.0%-6.0%,and there was no statistical significance between the groups(P>0.05).Pearson correlation analysis showed that the HCG level of pregnant women in the third trimester gestational periods was positively correlated with the FT4 level(r=0.311,P=0.028),and the HCG level of different gestational periods were negatively correlated with the TSH level(r=-0.103,P=0.048;r=-0.111,P=0.044;r=-0.149,P=0.030).Conclusion As the pregnancy cycle increases,HCG levels gradually decrease,while TSH levels continue to increase,and FT4 secretion decreases,which may increase the risk of thyroid dysfunction.Because HCG can have a certain impact on the pituitary-thyroid axis,thyroid function can be checked regularly according to the level of HCG changes,so as to effectively prevent or improve adverse pregnancy outcomes to ensure the health of pregnant women and fetuses.It is of high value for clinically reasonable intervention.