L-T4干预对甲减孕鼠自然流产状况的研究

发布时间：2018-02-21 01:58

本文关键词： 孕鼠甲状腺功能减退自然流产左旋甲状腺素治疗　出处：《山西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的甲状腺功能减退症是由多种原因导致的低甲状腺激素血症或甲状腺激素抵抗而引起的全身性低代谢性综合征，是由于甲状腺激素合成和分泌减少或组织利用不足所致。妊娠期间，随着母体甲状腺结构和分泌激素功能的改变，更容易导致甲状腺功能异常，临床上以甲状腺功能减退多见。甲状腺功能减退易引发不孕、自然流产、死胎、妊娠期高血压、早产、产后出血等不良妊娠结局，其对母儿的危害已引起国内外围产医学、内分泌学者的广泛关注。目前国内外研究一致认为在确定妊娠期甲状腺功能减退后，经及时足量使用左旋甲状腺素替代治疗，可改善不良妊娠结局。本研究旨在探讨经过左旋甲状腺素干预后的甲状腺功能减退症孕鼠自然流产的状况。方法将80只雌性大鼠随机取20只作为正常对照组，余60只利用丙硫氧嘧啶灌胃法创建甲状腺功能减退症大鼠模型，后随机分为两组：甲减组30只，甲减治疗组30只；甲减组继续给予丙硫氧嘧啶（PTU），甲减治疗组在给PTU的同时，给予L-T4干预；4周后观察各组动情周期；合笼前静脉采血，并用酶联免疫吸附实验（Elisa法）测定大鼠血清中FT4、TSH、TPO-Ab浓度，比较各组激素水平；合笼后观察所有大鼠的妊娠结局，统计各组所产的仔鼠数量。统计学方法采用SPSS17.0统计分析软件进行统计学分析。满足正态性和方差齐性，，统计学处理以均数加减标准差表示，计量资料采用t检验，计数资料采用χ2检验，检验水准α=0.05。结果光镜下显示患有甲状腺功能减退症的大鼠动情周期紊乱。甲减组与甲减治疗组相比FT4水平较低，TSH偏高，TPO-Ab偏高，均有显著性差异（P＜0.05）；甲减治疗组与正常对照组相比三种激素水平无显著性差异（P＞0.05）；正常对照组与甲减组相比，前者仔鼠数量多于后者,有显著性差异（P＜0.05）；甲减治疗组与正常对照组仔鼠数量相比无显著性差异（P＞0.05）。结论1.甲状腺功能减退症可致动情周期紊乱； 2.甲状腺功能减退症是导致自然流产的因素之一； 3.通过左旋甲状腺素替代治疗，可明显减少甲状腺功能减退症孕鼠自然流产的发生。
[Abstract]:Objective hypothyroidism is a systemic hypometabolic syndrome caused by hypothyroidism or thyroid hormone resistance. During pregnancy, with the changes of maternal thyroid gland structure and secretory hormone function, it is more likely to lead to abnormal thyroid function. Hypothyroidism is common in clinic. Hypothyroidism can easily lead to infertility, spontaneous abortion, stillbirth, gestational hypertension, preterm delivery, postpartum hemorrhage and other adverse pregnancy outcomes. Its harm to mother and infant has caused perinatal medicine at home and abroad. The current domestic and foreign studies agree that after the determination of hypothyroidism during pregnancy, levothyroxine replacement therapy is used in a timely and sufficient amount. The aim of this study was to investigate the spontaneous abortion of pregnant rats with hypothyroidism after levothyroxine intervention. Methods Twenty female rats were randomly selected as normal control group and the remaining 60 rats were randomly divided into two groups: hypothyroidism group (n = 30), hypothyroidism group (n = 30) and hypothyroidism group (n = 30). The hypothyroidism group continued to be treated with prothiouracil, while the hypothyroidism group received L-T4 intervention for 4 weeks to observe the estrous cycle, to collect blood from the precage vein, and to determine the concentration of TPO-Ab in the serum of rats by Elisa, and the concentration of TPO-Ab in the serum of rats was determined by enzyme linked immunosorbent assay (Elisa). The pregnant outcome of all rats was observed and the number of newborn rats in each group was counted. The statistical method was analyzed by SPSS17.0 statistical analysis software, which satisfied the normality and homogeneity of variance. The statistical processing is expressed as the mean plus or minus standard deviation, the measurement data is t test, the count data is 蠂 2 test, the test level is 伪 0. 05. Results under light microscope, the estrus cycle of rats with hypothyroidism was found to be in disorder, the FT4 level in hypothyroidism group was lower than that in hypothyroidism treatment group, and TPO-Ab level was higher in hypothyroidism group than in hypothyroidism group. There was no significant difference in the levels of three hormones between the hypothyroidism group and the normal control group (P > 0.05). There was significant difference (P < 0.05), but there was no significant difference between hypothyroidism group and normal control group (P > 0.05). Conclusion 1. Hypothyroidism can cause estrous cycle disorder; 2. Hypothyroidism is one of the factors leading to spontaneous abortion; 3. The occurrence of spontaneous abortion in pregnant rats with hypothyroidism was significantly reduced by levothyroxine replacement therapy.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.21

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