摘要
目的 探讨自然流产与血清内分泌激素水平的相关联。方法 回顾性研究2018-06至2019-10在医院门诊就诊,行孕前检查的非妊娠妇女178例。分为自然流产史组77例和无自然流产史组101例。比较两组女性血清性激素水平、甲状腺激素水平及血糖、胰岛素水平,并对自然流产史次数与合并疾病(女性内分泌疾病、甲状腺疾病、血糖及胰岛素异常)种数进行相关性研究。结果 自然流产史组的孕次(2.14±1.28)次、卵泡刺激素(FSH)[6.96(8.36,5.63)U/ml]、催乳激素(PRL)[23.00(35.66,15.67)μg/L]、睾酮(T)[0.70(1.04,0.44)ng/ml]、促甲状腺激素(TSH)[2.53(3.82,1.49)UIU/ml]、游离三碘甲状腺原氨酸(FT3)[4.29(5.24,2.99)pmol/L]、游离甲状腺素(FT4)[16.08(19.96,11.86)pmol/L]、抗甲状腺球蛋白抗体(TGAb)[20.00(39.00,9.00)U/ml]水平均高于无自然流产史组[(0.62±0.81)次、6.43(7.60,5.02)U/ml、16.24(22.87,8.70)μg/l、0.40(0.79,0.20)ng/ml、1.78(2.19,1.29)UIU/ml、4.47(5.87,3.87)pmol/l、18.55(20.79,14.93)pmol/L、33.00(45.30,13.20)U/ml],自然流产史组的孕酮(P)[0.24(0.46,0.10)ng/ml ]水平低于无自然流产史组[0.38(0.70,0.18)ng/ml],差异有统计学意义(P＜0.05);两组空腹、服糖后1 h、服糖后2 h,自然流产史组的胰岛素水平均高于无自然流产史组,差异均有统计学意义( P＜0.05),而空腹、服糖后1 h、服糖后2 h血糖水平两组差异无统计学意义。自然流产史次数与合并疾病数差异无统计学意义(r=0.064)。结论 血清高FSH、PRL、P、T,TSH、FT3、FT4、TGAb水平及胰岛素抵抗可能是导致自然流产的内分泌原因。
Abstract
Objective To study the correlations between women with previous spontaneous abortions and levels of endocrine hormone.Methods A retrospective study was carried out on 178 non pregnant women who received pre pregnancy examination in our hospital between June 2018 and October 2019.They were divided into the spontaneous abortion group(77 cases) and no spontaneous abortion group (101 cases).The levels of serum sex hormone ,thyroid hormone, blood glucose and insulin were compared between the two groups.The correlations between the number of times of spontaneous abortion and the types of combined diseases(female endocrine disease, thyroid disease, and abnormality of blood glucose and insulin)were studied.Results The number of times of pregnancy(2.14±1.28), levels of FSH [6.96(8.36,5.63)U/ml], PRL[23.00(35.66,15.67)μg/L],T[0.70(1.04,0.44)ng/ml], TSH[2.53(3.82,1.49)UIU/ml],FT3[4.29(5.24,2.99)pmol/L], FT4[16.08(19.96,11.86)pmol/L] and TGAb[20.00(39.00,9.00)U/ml] in the spontaneous abortion group were larger or higher than those in the no spontaneous abortion group[(0.62±0.81),6.43(7.60,5.02)U/ml,16.24(22.87,8.70)μg/L,0.40(0.79,0.20)ng/ml,1.78(2.19,1.29)UIU/ml,4.47(5.87,3.87) pmol/L, 18.55(20.79,14.93)pmol/L, 33.00(45.30,13.20)U/ml].The level of P[0.24(0.46,0.10)ng/ml ] in the spontaneous abortion group was lower than that of the no spontaneous abortion group[0.38(0.70,0.18)ng/ml],and the difference was of statistical significance (P＜0.05).The insulin level in the spontaneous abortion group was higher than that of the no spontaneous abortion group, and the difference was also statistically significant (P＜0.05).There was no statistically significant difference in the number of times of spontaneous abortion and types of combined diseases(r=0.064).Conclusions High levels of serum FSH,PRL,P,T,TSH,FT3,FT4,TGAb and insulin resistance may be endocrine factors leading to spontaneous abortion.
关键词
自然流产史 /
内分泌激素 /
相关性
Key words
spontaneouse abortion history /
endocrine hormone /
correlation
孙旸, 刘洪青, 薛红芳, 史海霞.
自然流产与女性血清内分泌激素的相关性[J]. 武警医学. 2020, 31(10): 857-860
SUN Yang, LIU Hongqing, XUE Hongfang, SHI Haixia.
Related factors of endocrine hormone in women with history of spontaneous abortion[J]. Medical Journal of the Chinese People Armed Police Forces. 2020, 31(10): 857-860
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参考文献
[1] 林其德.自然流产[M].北京:人民卫生出版社,2015: 5.
[2] 乔 杰.复发性流产孕期管理[J].中国实用妇科与产科杂志,2018,34(12):1309-1314.
[3] Huchon C, Deffieux X, Beucher G, et al. Pregnancy loss: french clinical practice guidelines[J]. Eur J Obstet Gynecol Reprod Biol, 2016, 201(6):18-26.
[4] Wu M, Zhu Y, Zhao J, et al. Soluble costimulatory molecule sTim3 regulates the differentiation of Th1 and Th2 in patients with unexplained recurrent spontaneous abortion[J].Int J Clin Exp Med,2015, 8(6):8812-8819.
[5] Melmed S, Casanueva F F, Hoffman A R, et al. Diagnosis and treatment of hyperprolactinemia: an endocrine society clinical practice guideline[J]. J Clin Endocrinol Metabol, 2011, 95:4268-4275.
[6] Chen H,Fu J, Huang W. Dopamine agonists for preventing future miscarriage in women with idiopathic hyperprolactinemia and recurrent miscarriage history[J]. Cochrane Database Syst Rev, 2016, 7:1-27.
[7] Ramandeep K, Kapil G. Endocrine dysfunction and recurrent spontaneous abortion: an overview[J]. Int J Applied Basic Med Res, 2016,6(2):79-83.m
[8] Nardo L G,Rai R,Backos M,et al.High serum luteinizing hormone and testosterone concentrations do not predict pregnancy outcome in women with recurrent miscarriage[J].Fertil Steril,2002, 77(2):348-352.
[9] Shrestha A, Tripathi P, Dongol A. Pregnancy outcomes in patients with hypothyroidism[J]. Kathmandu Univ Med J (KUMJ), 2019, 17(65):57-60.
[10] Uchida S, Maruyama T, Kagami M,et al. Impact of borderline-subclinical hypothyroidism on subsequent pregnancy outcome in women with unexplained recurrent pregnancy loss[J]. J Obstet Gynaecol Res,2017,43(6):1014-1020.
[11] Maraka A S,Ospina N M,O’keeffd T,et al.Subclinical hypothyroidism in pregnancy: a systematic review and meta-analysis [J].Thyroid,2016,26 (4):580-590.
[12] Hong L Y,Marren A.Recurrent pregnancy loss: a summary of international evidence-based guidelines and practice [J]. Aust J Gen Pract, 2018, 47(7):432-436.
[13] Asanidze E,Kristesashvili J,Andguladze S. Correlation between levels of homocysteine, anti -mullerina hormone and insulin resistance in PCOS patients with recurrent miscarriange [J].Georgian Med News, 2019,5(290):25-29.
[14] Katulski K,Czyzyk A,Podfigurna S A,et al. Pregnancy complications in polycystic ovary syndrome patients[J].Gynecol Endocrinol, 2015, 31(2): 87-91.
[15] Amouzegar A, Kazemian E, Gharibzadeh S,et al.Association between thyroid hormones, thyroid antibodies and insulin resistancein euthyroid individuals: a population-based cohort[J].Diabetes Metab,2015,41(6):480-488.
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