Carriero R, Andermann E, Chen M F, Eeg-Oloffson O, Kinch R A, Klein G, Murphy B E
Am J Obstet Gynecol. 1985 Mar 1;151(5):641-4. doi: 10.1016/0002-9378(85)90155-3.
It has been suggested that patients receiving anticonvulsant therapy have depressed thyroid function. Thyroid function was studied in 16 pregnant epileptic women who were receiving various anticonvulsants; 20 nonepileptic pregnant women served as controls. Maternal and umbilical cord blood was collected at delivery and serum thyrotropin, total thyroxine, triiodothyronine, triiodothyronine resin uptake, and free thyroxine levels were measured. The free thyroxine index was calculated from the thyroxine and triiodothyronine resin uptake data. There were no significant differences in any of the maternal parameters. In cord serum, the thyroxine level was significantly lower (p less than 0.001) in the infants of the epileptic mothers. The triiodothyronine resin uptake was slightly increased in the epileptic group (p less than 0.05) so that the free thyroxine index largely compensated for this. The thyrotropin, free thyroxine, and triiodothyronine levels did not differ between the two groups. Thus the low thyroxine values in cord blood of infants of epileptic mothers receiving anticonvulsants probably reflect an alteration in protein binding rather than a true alteration in thyroid function.
有人提出接受抗惊厥治疗的患者甲状腺功能会受到抑制。对16名正在接受各种抗惊厥药物治疗的妊娠癫痫妇女的甲状腺功能进行了研究；20名非癫痫妊娠妇女作为对照。在分娩时采集母体和脐带血，并测定血清促甲状腺素、总甲状腺素、三碘甲状腺原氨酸、三碘甲状腺原氨酸树脂摄取量和游离甲状腺素水平。根据甲状腺素和三碘甲状腺原氨酸树脂摄取数据计算游离甲状腺素指数。母体的任何参数均无显著差异。在脐带血清中，癫痫母亲的婴儿的甲状腺素水平显著较低（p小于0.001）。癫痫组的三碘甲状腺原氨酸树脂摄取量略有增加（p小于0.05），因此游离甲状腺素指数在很大程度上对此起到了补偿作用。两组之间的促甲状腺素、游离甲状腺素和三碘甲状腺原氨酸水平没有差异。因此，接受抗惊厥药物治疗的癫痫母亲的婴儿脐带血中甲状腺素值较低可能反映的是蛋白质结合的改变，而不是甲状腺功能的真正改变。
