Swaminathan R, Chin R K, Lao T T, Mak Y T, Panesar N S, Cockram C S
Department of Chemical Pathology, Prince of Wales Hospital, Hong Kong.
Acta Endocrinol (Copenh). 1989 Feb;120(2):155-60. doi: 10.1530/acta.0.1200155.
Plasma total T4 (TT4), T3 (TT3), free T4 (FT4), free T3 (FT3), thyroxine binding globulin, hCG, and erythrocyte zinc content were measured in 43 women with uncomplicated pregnancy and in 71 patients admitted with hyperemesis gravidarum. Plasma concentration of thyroid hormones in hyperemesis subjects showed wide variability and 32% of subjects had high TT4 (higher than mean +2 SD of normal pregnant subjects), 33% had high FT4, 20% had high TT3, and 20% had high FT3. Red cell zinc content, a tissue marker of thyroid status, in the hyperthyroxinemic subjects was not different from that of normothyroxinemic hyperemesis subjects or of subjects with uncomplicated pregnancy. The elevated TT4 concentration decreased spontaneously in all but two of the hyperemesis subjects to normal pregnant levels. The plasma FT4 concentration at presentation correlated with plasma hCG in hyperemesis gravidarum (partial correlation coefficient r = 0.411, P less than 0.01), but not in normal pregnancy (partial correlation coefficient r = 0.043) after allowing for the effect of gestational age. We conclude that approximately one third of hyperemesis subjects show transient hyperthyroxinemia and suggest that hCG or a molecular variant of hCG may stimulate the thyroid gland.
对43例正常妊娠女性和71例妊娠剧吐患者测定了血浆总甲状腺素（TT4）、总三碘甲状腺原氨酸（TT3）、游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）、甲状腺素结合球蛋白、人绒毛膜促性腺激素（hCG）以及红细胞锌含量。妊娠剧吐患者的血浆甲状腺激素浓度差异很大，32%的患者TT4升高（高于正常妊娠女性平均值+2标准差），33%的患者FT4升高，20%的患者TT3升高，20%的患者FT3升高。甲状腺功能状态的组织标志物——红细胞锌含量，在甲状腺素血症患者中与甲状腺素正常的妊娠剧吐患者或正常妊娠女性并无差异。除两名妊娠剧吐患者外，所有患者升高的TT4浓度均自发降至正常妊娠水平。在考虑孕周影响后，妊娠剧吐患者就诊时的血浆FT4浓度与血浆hCG相关（偏相关系数r = 0.411，P<。我们得出结论，约三分之一的妊娠剧吐患者表现为短暂性甲状腺素血症，并提示hCG或hCG的分子变体可能刺激甲状腺。 01），但正常妊娠患者中两者不相关（偏相关系数r = 0.043）
