Kennedy R L, Darne J, Davies R, Price A
Department of Medicine, Northern General Hospital, Sheffield, UK.
Clin Endocrinol (Oxf). 1992 Jan;36(1):83-9. doi: 10.1111/j.1365-2265.1992.tb02906.x.
To investigate in-vitro thyroid stimulatory activity in the serum of patients with hyperemesis gravidarum and thyrotoxicosis.
Serum from hyperthyroid patients was incubated with cultures of human thyroid cells. Attempts were made to neutralize stimulatory activity with antisera to hCG.
Five patients presenting in early pregnancy with hyperemesis and thyrotoxicosis.
Serum concentrations of thyroid hormones (total and free), TSH and hCG. Accumulation of extracellular cAMP in response to serum.
All five patients had biochemical hyperthyroidism with no evidence of an underlying autoimmune disease. The mean cAMP accumulation over 4 hours with sera from 12 non-pregnant controls was 130.6 (121.8-142.8), from 12 pregnant controls 132.4 (118.1-143.8), compared with values of 144.7, 159.1, 166.2, 178.9 and 320.5 for the thyrotoxic patients. The stimulatory activity could not be neutralized by addition of anti-hCG or by depleting the sera of hCG.
Thyrotoxicosis may present with hyperemesis in early pregnancy. Clinical and biochemical features may be masked by the pregnancy or by the intercurrent illness. The hypothesis that hCG is a thyroid stimulator in patients with hyperemesis gravidarum is not supported by the immuno-neutralization data in this study.
研究妊娠剧吐合并甲状腺毒症患者血清的体外甲状腺刺激活性。
将甲状腺功能亢进患者的血清与人甲状腺细胞培养物一起孵育。尝试用抗人绒毛膜促性腺激素（hCG）抗血清中和刺激活性。
5例孕早期出现妊娠剧吐和甲状腺毒症的患者。
甲状腺激素（总甲状腺激素和游离甲状腺激素）、促甲状腺激素（TSH）和hCG的血清浓度。血清刺激后细胞外环磷酸腺苷（cAMP）的蓄积量。
所有5例患者均有生化性甲状腺功能亢进，无潜在自身免疫性疾病的证据。12名非妊娠对照者血清4小时内cAMP的平均蓄积量为130.6（121.8 - 142.8），12名妊娠对照者为132.4（118.1 - 143.8），而甲状腺毒症患者的值分别为144.7、159.1、166.2、178.9和320.5。添加抗hCG或去除血清中的hCG均不能中和刺激活性。
甲状腺毒症在孕早期可能表现为妊娠剧吐。临床和生化特征可能被妊娠或并发疾病掩盖。本研究的免疫中和数据不支持hCG是妊娠剧吐患者甲状腺刺激物的假说。
