妊娠期合并甲亢对新生儿TGF-β1、FGF-21的影响

Influence of Hyperthyroidism during Pregnancy on Transforming Growth Factor-β1 and Plasma Fibroblast Growth Factor-21 in Neonates

目的:探讨妊娠期合并甲亢对新生儿转化生长因子β1(transforming growth factor,TGF-β1)及血浆成纤维细胞生长因子21(fibroblast growth factor 21,FGF-21)的影响。方法:选取2017年1月-2019年12月本院收治的63例妊娠期病情得到控制的甲亢产妇及其新生儿作为临床控制组,63例妊娠期病情未得到控制的甲亢产妇及其新生儿作为临床未控制组,另选取同期于本院分娩的63例健康产妇及其新生儿作为健康对照组。回顾性分析三组产妇及新生儿的临床资料。比较三组产妇及新生儿游离三碘甲腺原氨酸(free triiodothyronine,FT_(3))、游离甲状腺素(free thyroxine,FT_(4))、促甲状腺素(thyroid stimulating hormone,TSH)水平;比较三组新生儿血尿素氮(blood urea nitrogen,BUN)、血肌酐(crea,Cr)、FGF-21及TGF-β1水平;分析BUN、Cr与FGF-21、TGF-β1的相关性。结果:临床未控制组产妇分娩前FT_(3)、FT_(4)水平均高于临床控制组与健康对照组产妇,TSH水平低于临床控制组和健康对照组产妇(P<0.05);临床未控制组新生儿FT_(3)、FT_(4)水平均高于临床控制组和健康对照组新生儿,TSH水平低于临床控制组和健康对照组新生儿(P<0.05)。临床未控制组新生儿BUN、Cr、TGF-β1、FGF-21水平均高于临床控制组和健康对照组新生儿(P<0.05);临床未控制组新生儿TGF-β1、FGF-21与BUN、Cr均呈正相关(P<0.05)。结论:妊娠期病情未得到控制的甲亢产妇分娩的新生儿甲状腺功能与肾功能均较健康产妇分娩的新生儿低下,TGF-β_(1)、FGF-21水平高于健康产妇分娩的新生儿,新生儿甲状腺功能及肾功能损伤和TGF-β1、FGF-21、妊娠期合并甲亢有关。为提高新生儿生命质量,及时发现新生儿早期甲状腺以及肾损害,建议同时监测FT_(3)、FT_(4)、TSH、BUN、Cr、FGF-21、TGF-β1。

Objective:To investigate the influence of hyperthyroidism during pregnancy on TGF-β1 and FGF-21 in the newborns.Method:A total of 63 hyperthyroidism parturient with controlled conditions during pregnancy and their newborns in our hospital from January 2017 to December 2019 were selected as the clinically controlled group.63 hyperthyroidism parturient with uncontrolled conditions during pregnancy and their newborns were selected as the clinically uncontrolled group.Another 63 healthy parturient and their newborns who delivered in our hospital during the same period were selected as healthy control group.The clinical data of parturient and their newborns in the three groups were retrospectively analyzed.The levels of free triiodothyronine(FT_(3)),free thyroxine(FT_(4))and thyroid stimulating hormone(TSH)of parturient and their newborns were compared among the three groups.The levels of blood urea nitrogen(BUN),blood creatinine(CREA),FGF-21 and TGF-β1 of newborns were compared among the three groups.The correlation of BUN,Cr with FGF-21 and TGF-β1 was analyzed.Result:Before delivery,the levels of FT_(3) and FT_(4) of parturient in clinically uncontrolled group were higher than those in clinically controlled group and healthy control group,while the levels of TSH were lower than those in clinically controlled group and healthy control group(P<0.05).The levels of FT_(3) and FT_(4) of newborns in the clinically uncontrolled group were higher than those in the clinically controlled and the healthy control group,while the levels of TSH were lower than those in the clinically controlled group and the healthy control group(P<0.05).The levels of BUN,Cr,TGF-β1 and FGF-21 in newborns in clinically uncontrolled group were higher than those in clinically controlled group and healthy control group(P<0.05).TGF-β1 and FGF-21 of newborns in the clinically uncontrolled group were positively correlated with BUN and Cr(P<0.05).Conclusion:The thyroid and renal functions of the newborns in the pregnant women with uncontrolled hyperthyroidism are lower than those in the normal pregnant women.The levels of TGF-β1 and FGF-21 are higher than those in the normal pregnant women.The damage of thyroid and renal functions,and the levels of FGF-21 and TGF-β1 in the newborns is related to hyperthyroidism in his mothers.In order to improve the quality of life of newborns and find out the early thyroid and renal damage,it is suggested to monitor FT_(3),FT_(4),TSH,BUN,Cr,FGF-21 and TGF-β1 at the same time.