子痫前期孕妇甲状腺功能、血清PLGF、HCT与胎儿生长受限关系

Correlation between the serum thyroid function,the placental growth factor,and the hematocrit levels of pregnant women with preeclampsia and their fetal growth restriction

目的:探讨子痫前期(PE)孕妇甲状腺功能变化及其血清胎盘生长因子(PLGF)和红细胞压积(HCT)水平与胎儿生长受限(FGR)发生关系。方法:选择2020年6月-2021年12月本院妇产科收治并分娩的PE孕妇108例,其中并发FGR 42例为并发组,未并发FGR 66例为非并发组,同期住院分娩的正常产妇55例为对照组。采用免疫分析法检测血清促甲状腺激素(TSH)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPO-Ab)以及PLGF和HCT水平,并分析其与FGR发生关系。结果:对照组、非并发组、并发组甲状腺功能异常发生率依次升高,3组血清TSH、FT4、PLGF、HCT水平有差异(均P<0.05);而3组TPO-Ab无差异(P>0.05);对照组、非并发组、并发组血清TSH、HCT依次升高,FT4、PLGF依次减小(均P<0.05)。多因素logistic回归分析显示,甲状腺功能异常、血清PLGF降低、HCT≥0.35是子痫前期孕妇出现FGR的独立危险因素(P<0.05)。结论:甲状腺功能、PLGF、HCT水平发生异常是子痫前期孕妇发生FGR危险因素,临床应加以关注。

Objective:To investigate the correlation between the thyroid function,the serum placental growth factor(PLGF),and the hematocrit(HCT)levels of pregnant women with preeclampsia(PE)and their fetal growth restriction(FGR).Methods:108pregnant women with PE admitted and delivered in hospital were selected in study group from June 2020to December 2021.Among them,42cases with FGR were in group A and 66cases without FGR were in group B.55normal pregnant women were selected in group C during the same period.The serum levels of thyroid stimulating hormone(TSH),free thyroxine(FT4),thyroid peroxidase antibody(TPO-Ab),PLGF,and HCT of the women in the three groups were measured by immunoassay,and the correlation between which and the FGR occurrence of the women was analyzed.Results:The incidence of the thyroid dysfunction of the women in group C,in group B,and in group A had increased gradually,and the serum levels of TSH,FT4,PLGF,and HCT of the women had significant differences among the three groups(all P<0.05).There was no significant difference in the TPO-Ab level of the women among the three groups(P>0.05).The serum TSH and HCT levels of the women in group C,in group B,and in group A had increased gradually,while the FT4level of the women in group C,in group B,and in group A had decreased gradually(all P<0.05).Further logistic regression analysis showed that the thyroid dysfunction,the decreased serum PLGF level,and the HCT level≥0.35of the women with PE were the independent risk factors of their FGR occurrence(P<0.05).Conclusion:The abnormal thyroid function changes and the serum PLGF and HCT levels of the pregnant women with PE are the risk factors of their FGR occurrence,and which should be paid more attention to in clinic.