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目的:观察正常妊娠人群血清中转甲状腺素蛋白(TTR)浓度在孕期的变化,探讨血清TTR浓度在子痫前期诊断和监测病情中的价值。方法:(1)无并发症及合并症的正常妇女62例,分别于孕前、孕12~16周、20~24周、28~32周和37~41周留取静脉血清。(2)无产科并发症及内外科合并症正常孕妇50例作为对照组,诊断为妊娠期高血压疾病的孕妇分为重度子痫前期组(SPE组,30例)和妊娠期高血压、妊娠合并慢性高血压及轻度子痫前期组(GHD组,49例)。SPE组和GHD组分别于诊断时留取静脉血清,对照组分别在相应孕周留取外周静脉血清。ELISA法测定血清TTR浓度。结果:正常妇女TTR血清水平:孕前(245.65±5.02)mg/L,孕12~16周、20~24周、28~32周和37~41周血清TTR浓度分别为(649.86±43.40)mg/L、(856.10±52.28)mg/L、(410.04±22.82)mg/L、(413.71±24.17)mg/L。SPE组孕妇血清TTR浓度[(86.58±10.23)mg/L]显著低于对照组[(411.64±25.80)mg/L]及GHD组[(468.59±42.93)mg/L](P<0.05);GHD组与对照组比较差异无统计学意义(P>0.05)。结论:TTR血浆浓度在未孕时最低,随孕周增加逐渐升高,孕20~24周时达高峰,之后快速下降,到孕晚期与孕早期持平。TTR在监测病情变化及对治疗反应方面可能有一定的意义。
Objective: To observe the change of serum thyrotrophin (TTR) concentration in normal pregnant women during pregnancy and to explore the value of serum TTR concentration in the diagnosis and monitoring of preeclampsia. Methods: (1) Sixty-two normal women without complications and complications were enrolled in this study. Venous sera were collected before pregnancy, 12-16 weeks of pregnancy, 20-24 weeks, 28-32 weeks and 37-41 weeks respectively. (2) Fifty pregnant women with obstetric complications and surgical complications were included in the study. Pregnant women diagnosed with gestational hypertension were divided into severe preeclampsia group (30 cases) and pregnancy-induced hypertension Combined with chronic hypertension and mild preeclampsia group (GHD group, 49 cases). In the SPE group and the GHD group, venous sera were collected at the time of diagnosis and peripheral venous sera were collected from the control group at the corresponding gestational weeks. Serum TTR concentration was measured by ELISA. Results: TTR serum levels in normal women before pregnancy (245.65 ± 5.02) mg / L, gestational weeks 12-16, 20-24, 28-32 and 37-41 weeks were (649.86 ± 43.40) mg / L, (856.10 ± 52.28) mg / L, (410.04 ± 22.82) mg / L and (413.71 ± 24.17) mg / L, respectively. Compared with control group [(411.64 ± 25.80) mg / L] and GHD group [(468.59 ± 42.93) mg / L] (P <0.05), serum TTR concentration in pregnant women with SPE group was significantly lower than that in the control group [(86.58 ± 10.23) mg / There was no significant difference between GHD group and control group (P> 0.05). CONCLUSION: The plasma TTR concentration is the lowest in non-pregnant rats and increases gradually with gestational age. It reaches a peak at 20-24 weeks of pregnancy and then decreases rapidly, reaching the same level in the third trimester of pregnancy. TTR may have some implications in monitoring changes and responding to treatment.