甲状腺功能减退与女性不孕症的相关研究
发布时间：2018-10-31 06:18
【摘要】：目的：通过检测不孕症组与对照组甲状腺激素水平及性激素水平,探讨甲状腺激素功能减退与女性不孕症的关系及临床意义。现今女性不孕症有日渐升高的趋势,甲状腺功能减退因素导致不孕受到广泛的关注,甲状腺功能减退症作为一种最常见的自身免疫性疾病,多见于性成熟女性,女性患者常伴有月经失调、闭经、溢乳,甚至导致不孕症的发生。另一方面,甲状腺功能紊乱会影响性激素分泌水平及性腺功能,进而造成女性患者出现月经紊乱卵巢功能减退,排卵异常不孕。探讨甲状腺功能减退对不孕症的影响,进一步观察甲状腺功能减退患者性激素水平的变化,研究其下丘脑-垂体-性腺轴的变化规律,对女性不孕预防及治疗具有重要的临床意义。方法：研究实验对象选择自2012年10月至2013年10月期间在石家庄市第四医院就诊进行不孕症检查的妇女(非输卵管因素及男方因素者)500例,年龄21岁～40岁,中位数年龄32岁。入选标准：婚后同居1年以上,未采取避孕措施而未孕者,或曾有孕育而后1年以上未再孕育女性,而且排除因输卵管因素和男方因素导致不孕的患者。正常对照组选取门诊健康体检女性1 00例,年龄22岁～40岁。入选标准：a.排除甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)j阳性者；b.排除甲状腺疾病个人史、家族史或其他自身免疫性疾病史；c.排除可见或者可以触及的甲状腺肿；d.排除服用药物者(雌激素类除外)。采用固相化学发光酶免疫分析法,空腹测定被检者血清中游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH),及性激素六项：促卵泡成熟激素(FSH)、促黄体生成激素(LH)、催乳激素(PRL)、雌二醇(E2)、睾酮(T)和孕酮(P)。数据得出后分别比较对照组与不孕组FT3,FT4,TSH和性激素六项,不孕组内甲状腺激素TSH变化模式所占比例,不孕TSH超范围组与不孕对照组性激素六项对照。检测数据以x±s表示,应用SPSS13.0软件进行处理,组间分析比较采用t检验,以P0.05为差异具有统计学意义。结果：不孕组TSH含量明显高于对照组,两组比较差异有显著性(尸0.01),不孕组FT3,FT4差异无显著性(P0.05)；不孕组中,TSH升高伴月经异常无明显甲减症状所占比例为10.3%；不孕组的E2明显低于对照组,两组比较差异有统计学意义(P0.05)；不孕组的LH、FSH、PRL明显高于正常对照组,两组比较差异有统计学意义(P0.05),不孕组的T和P与对照组相比差异无统计学意义(P0.05)；不孕组中TSH异常升高的92例患者LH、FSH、PRL明显高于不孕组中TSH正常的其他患者,差异有统计学意义(P0.05)。结论：1甲状腺功能减退是导致女性不孕症的原因之一。2 TSH单独升高,表明临床亚临床甲状腺功能减退比例高,可导致不孕症发生,不存在年龄差异。3甲状腺功能减退导致不孕症高发年龄为36-40岁育龄女性。4甲状腺功能低下可导致雌激素水平降低,LH、FSH、PRL升高,影响卵巢功能,使卵泡发育不良,内膜变薄,导致不孕。
[Abstract]:Objective: To investigate the relationship between hypothyroidism and female infertility and its clinical significance by detecting thyroid hormone level and sex hormone level in infertility group and control group. Because of the increasing trend of female infertility, the factors of hypothyroidism lead to the widespread concern of infertility, hypothyroidism as one of the most common autoimmune diseases, often seen in female and female patients with menstrual disorders, amenorrhea, galactorrhoea, even causing infertility. On the other hand, thyroid function disorder can affect sex hormone secretion level and gonadal function, which causes female patient to suffer menstrual disorder ovarian function decline, ovulation abnormal infertility. To study the effect of hypothyroidism on infertility, and to further observe the change of sex hormone level in patients with hypothyroidism, and to study the change law of hypothalamus-pituitary-gonadal axis, which has important clinical significance for the prevention and treatment of female infertility. Methods: 500 women, aged 21 to 40 years, with median age of 32 years, were selected from October 2012 to October 2013. Inclusion criteria: after 1 year of cohabitation after marriage, no pregnant women were taken, or pregnant women were not pregnant for more than 1 year, and patients with infertility caused by tubal factor and teratogenic factors were excluded. In the normal control group, there were 100 women in the outpatient health examination, aged 22 to 40 years old. Inclusion criteria: a. elimination of thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb) j-positive; b. exclusion of individual history of thyroid disease, family history or other autoimmune disease history; c. elimination of visible or palpable goiter; d. Excludes drug users (other than estrogen). The serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH) and sex hormone 6: follicle stimulating hormone (FSH) and luteinizing hormone (LH) were determined by solid phase chemiluminescence enzyme immunoassay. prolactin (PRL), estradiol (E2), testosterone (T) and progesterone (P). Six controls were compared between control group and infertile group, FT3, FT4, TSH, sex hormone, thyroid hormone TSH in infertility group and infertility control group. The test data was expressed by x/ s, and the SPSS 13.0 software was used for the treatment. The t-test was used for the intergroup analysis, and the difference was statistically significant with P0.05. Results: The content of TSH in infertile group was significantly higher than that in control group (P <0.01), there was no significant difference between FT3 and FT4 in infertile group (P0.05). The difference of LH, FSH and PRL in infertile group was significantly higher than that in normal control group (P0.05). LH, FSH and PRL of 92 patients with abnormal TSH in infertility group were significantly higher than those of other patients with normal TSH in infertility group (P <0.05). Conclusion: 1 hypothyroidism is one of the causes of female infertility. TSH alone increases, indicating that the ratio of clinical subclinical hypothyroidism is high, which can lead to infertility. There is no age difference. 3 hypothyroidism results in a high incidence of infertility of 36-40 years old female. The low thyroid function can lead to lower estrogen level, LH, FSH, PRL increase, affect ovarian function, cause follicular dysplasia, thinning of endometrium, and lead to infertility.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R581.2;R711.6
本文编号：2301196
[Abstract]:Objective: To investigate the relationship between hypothyroidism and female infertility and its clinical significance by detecting thyroid hormone level and sex hormone level in infertility group and control group. Because of the increasing trend of female infertility, the factors of hypothyroidism lead to the widespread concern of infertility, hypothyroidism as one of the most common autoimmune diseases, often seen in female and female patients with menstrual disorders, amenorrhea, galactorrhoea, even causing infertility. On the other hand, thyroid function disorder can affect sex hormone secretion level and gonadal function, which causes female patient to suffer menstrual disorder ovarian function decline, ovulation abnormal infertility. To study the effect of hypothyroidism on infertility, and to further observe the change of sex hormone level in patients with hypothyroidism, and to study the change law of hypothalamus-pituitary-gonadal axis, which has important clinical significance for the prevention and treatment of female infertility. Methods: 500 women, aged 21 to 40 years, with median age of 32 years, were selected from October 2012 to October 2013. Inclusion criteria: after 1 year of cohabitation after marriage, no pregnant women were taken, or pregnant women were not pregnant for more than 1 year, and patients with infertility caused by tubal factor and teratogenic factors were excluded. In the normal control group, there were 100 women in the outpatient health examination, aged 22 to 40 years old. Inclusion criteria: a. elimination of thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb) j-positive; b. exclusion of individual history of thyroid disease, family history or other autoimmune disease history; c. elimination of visible or palpable goiter; d. Excludes drug users (other than estrogen). The serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH) and sex hormone 6: follicle stimulating hormone (FSH) and luteinizing hormone (LH) were determined by solid phase chemiluminescence enzyme immunoassay. prolactin (PRL), estradiol (E2), testosterone (T) and progesterone (P). Six controls were compared between control group and infertile group, FT3, FT4, TSH, sex hormone, thyroid hormone TSH in infertility group and infertility control group. The test data was expressed by x/ s, and the SPSS 13.0 software was used for the treatment. The t-test was used for the intergroup analysis, and the difference was statistically significant with P0.05. Results: The content of TSH in infertile group was significantly higher than that in control group (P <0.01), there was no significant difference between FT3 and FT4 in infertile group (P0.05). The difference of LH, FSH and PRL in infertile group was significantly higher than that in normal control group (P0.05). LH, FSH and PRL of 92 patients with abnormal TSH in infertility group were significantly higher than those of other patients with normal TSH in infertility group (P <0.05). Conclusion: 1 hypothyroidism is one of the causes of female infertility. TSH alone increases, indicating that the ratio of clinical subclinical hypothyroidism is high, which can lead to infertility. There is no age difference. 3 hypothyroidism results in a high incidence of infertility of 36-40 years old female. The low thyroid function can lead to lower estrogen level, LH, FSH, PRL increase, affect ovarian function, cause follicular dysplasia, thinning of endometrium, and lead to infertility.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R581.2;R711.6
【参考文献】
相关期刊论文 前1条
1 杜忠芳,陈燕,董明国,石应元,刘建华,程鹏飞;240例甲亢、甲低患者血清性激素测定分析[J];中华核医学杂志;2002年05期
，本文编号：2301196
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