Mekaru Keiko, Kamiyama Shigeru, Masamoto Hitoshi, Sakumoto Kaoru, Aoki Yoichi
Department of Obstetrics and Gynecology, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
Gynecol Endocrinol. 2008 Sep;24(9):498-501. doi: 10.1080/09513590802246364.
The objective of the present study was to evaluate the effect of an oil-soluble iodinated contrast medium (lipiodol) for hysterosalpingography (HSG) on thyroid function.
In 214 of 528 women with infertility examined by HSG using lipiodol between 1996 and 2006 at our institution, serum free thyroxine (FT4) and thyrotropin-stimulating hormone (TSH) were measured before and several months after HSG.
The average age of the women was 34.5 +/- 4.6 years and their average infertility period was 2.9 +/- 2.5 years (mean+/-standard deviation). The 214 patients were divided into three groups based on the results of thyroid function before HSG: 180 in euthyroid, 28 in subclinical hypothyroidism and 13 in subclinical hyperthyroidism. The number of patients in the subclinical hypothyroidism group who developed hypothyroidism after HSG (ten of 28) was significantly higher than that of the euthyroid group (four of 180). Thyroid hormone replacement was required in three patients from the subclinical hypothyroidism group 1, 2 and 5 months after HSG.
We conclude that thyroid function should be monitored closely after HSG using lipiodol to detect the development of hypothyroidism, particularly in patients with subclinical hypothyroidism, and TSH and FT4 measurements should be performed before HSG to identify patients at risk for hypothyroidism.
本研究的目的是评估油溶性碘化造影剂（碘油）用于子宫输卵管造影（HSG）对甲状腺功能的影响。
1996年至2006年在我们机构对528例不孕女性进行了使用碘油的HSG检查，其中214例在HSG前及HSG后数月检测了血清游离甲状腺素（FT4）和促甲状腺激素（TSH）。
这些女性的平均年龄为34.5±4.6岁，平均不孕时间为2.9±2.5年（均值±标准差）。根据HSG前甲状腺功能结果将214例患者分为三组：甲状腺功能正常者180例，亚临床甲状腺功能减退者28例，亚临床甲状腺功能亢进者13例。亚临床甲状腺功能减退组中HSG后发生甲状腺功能减退的患者数量（28例中的10例）显著高于甲状腺功能正常组（180例中的4例）。亚临床甲状腺功能减退组中有3例患者在HSG后1、2和5个月需要甲状腺激素替代治疗。
我们得出结论，使用碘油进行HSG后应密切监测甲状腺功能，以发现甲状腺功能减退的发生，尤其是亚临床甲状腺功能减退患者，并且在HSG前应进行TSH和FT4测量，以识别有甲状腺功能减退风险的患者。
