周青雪　施晓春　施新颜　董世雷

[關键词] 妊娠期;人绒毛膜促性腺激素;促甲状腺激素;游离甲状腺素

[中图分类号] R714.1          [文献标识码] A          [文章编号] 1673-9701（2021）17-0013-04

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

ZHOU Qingxue1   SHI Xiaochun1   SHI Xinyan1   DONG Shilei2

1.Department of Laboratory Medicine， Hangzhou Obstetrics and Gynecology Hospital， Hangzhou   310008， China; 2.Department of Laboratory Medicine， Zhejiang Hospital Affiliated to Zhejiang University School of Medicine， Hangzhou 310013， China

[Abstract] 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.

[Key words] Pregnancy period; Human chorionic gonadotropin; Thyroid stimulating hormone; Free thyroxine

妊娠期女性甲状腺疾病是妊娠期女性除糖尿病以外最常见的一种内分泌疾病，如妊娠合并甲亢、甲减以及产后甲状腺炎等。处于妊娠期的女性，体内激素代谢水平以及母体免疫状态都会发生一系列变化，往往容易引起甲状腺功能的变化。若甲状腺功能紊乱，继而影响母体对胎儿的甲状腺激素供应，对胎儿神经发育产生危害[1-3]。因此，加强妊娠期女性甲状腺功能的检测，将有利于病因学研究及相应疾病治疗，此外还可以有效预防和减少孕妇甲状腺功能紊乱。近年来，有关人绒毛膜促性腺激素（Human chorionic ggonadotropin，HCG）与促甲状腺激素（Thyroid stimulating hormone，TSH）的相关性研究显示两者密切相关[4]。由于HCG与TSH的结构相似，HCG水平可能参与了孕期女性甲状腺功能的发生与发展，但目前与之相关的报告较少。所以，本研究选取来本院就诊的150例不同妊娠期女性，对其血清HCG水平与TSH、游离甲状腺素（Free thyroxine，FT4）水平之间的相关性进行探讨，有助于为妊娠女性甲状腺疾病的早期监测和治疗提供可靠理论依据，现报道如下。

1 资料与方法

1.1 一般资料

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妊娠期女性150例，根据妊娠周期不同分为妊娠早期（1～12周）50例、妊娠中期（13～27周）50例和妊娠晚期（28～40周）50例。所有入选者均为已停经4～36周的妊娠期女性，单胎妊娠，初产妇，无明显甲状腺腫大，无甲状腺……