Leylek O A, Cetin A, Toyaksi M, Erselcan T
Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey.
Int J Gynaecol Obstet. 1996 Oct;55(1):33-7. doi: 10.1016/0020-7292(96)02737-3.
To evaluate the hormonal and hematologic parameters of 24 patients with hyperemesis gravidarum without evidence of thyroid disease compared with matched controls.
Twenty-four pregnant women with hyperemesis and 20 control subjects were included in this study. A prospective comparison of hormonal milieu of hCG and thyroid function was performed.
Mean serum hCG, fT3, and fT4 levels of patients were significantly higher than those of controls (P < 0.007), while there was no statistically significant difference in terms of TSH. Serum hCG correlated negatively with TSH and positively with fT3 and fT4 in the patient group (r = 0.66, r = 0.70, r = 0.85; P < 0.05, respectively), while there was no relationship between hCG and thyroid functions in controls (r < 0.25). The lymphocyte count of patients was significantly higher than that of controls (P < 0.007), while there were no statistically significant differences in the overall white blood count and the granulocyte count (P > 0.007). The lymphocyte count correlated positively with serum hCG, fT4 and fT3, and negatively with TSH in the patient group (r = 0.73, r = 0.72, r = 0.64 and r = -0.63; P < 0.05, respectively), while there was no relationship between lymphocyte count and serum hCG, fT4, fT3 and TSH in controls (r < 0.25).
Maternal immune recognition of the conceptus and immune response, hypothetically, may be related to the high level of hCG and/or fT4. Patients who have hyperthyroidism in early pregnancy should be assessed for transient hyperthyroidism as it relates to hyperemesis gravidarum.
评估24例无甲状腺疾病证据的妊娠剧吐患者与匹配对照组的激素和血液学参数。
本研究纳入了24例妊娠剧吐孕妇和20例对照受试者。对hCG的激素环境和甲状腺功能进行了前瞻性比较。
患者的平均血清hCG、游离三碘甲状腺原氨酸（fT3）和游离甲状腺素（fT4）水平显著高于对照组（P<0.007），而促甲状腺激素（TSH）方面无统计学显著差异。在患者组中，血清hCG与TSH呈负相关，与fT3和fT4呈正相关（r分别为0.66、0.70、0.85；P均<0.05），而在对照组中hCG与甲状腺功能之间无相关性（r<0.25）。患者的淋巴细胞计数显著高于对照组（P<0.007），而白细胞总数和粒细胞计数无统计学显著差异（P>0.007）。在患者组中，淋巴细胞计数与血清hCG、fT4和fT3呈正相关，与TSH呈负相关（r分别为0.73、0.72、0.64和 -0.63；P均<0.05），而在对照组中淋巴细胞计数与血清hCG、fT4、fT3和TSH之间无相关性（r<0.25）。
假设母体对胚胎的免疫识别和免疫反应可能与hCG和/或fT4的高水平有关。早期妊娠出现甲状腺功能亢进的患者应评估是否为与妊娠剧吐相关的短暂性甲状腺功能亢进。
