L-T4干预对甲状腺功能减退症大鼠生殖、妊娠结局的影响

发布时间：2018-11-25 20:28

【摘要】：目的：探讨甲状腺功能减退症的孕前干预对大鼠生殖及妊娠结局的影响，进一步证实甲状腺功能减退症早发现早治疗的必要性，为临床上育龄期妇女孕前甲功检查及甲状腺功能减退症治疗的必要性提供有力的依据。方法：将wistar雌性大鼠随机分为正常对照组（A组）、甲状腺功能减退症组（B1组）、甲状腺功能减退症干预组（B2组）；对B1、B2组通过持续给予丙硫氧嘧啶（propylthiouracil，PTU）灌胃的方法建立甲状腺功能减退大鼠模型，同时A组给予自来水灌胃；建模成功后，B1组继续给PTU、B2组在给PTU的同时给予左甲状腺素（L-T4）干预、A组继续自来水灌胃；4周之后每日清晨行阴道细胞涂片、常规HE染色等方法，分别监测三组大鼠动情周期（相当于人类的月经周期）的改变。随后令所有雌性大鼠同时与正常雄鼠合笼交配，；采用发光免疫法检测各组大鼠血清中FT4、TPO-Ab、TSH的浓度变化；对比三组大鼠生殖、妊娠结局的不同；最后采用SPSS17.0统计软件对实验数据进行统计学分析，满足正态性和方差齐性，计量资料采用x s（均数±标准差）作为参数，组间比较采用t检验，检验水准α=0.05。计数资料组间比较采用2检验，检验水准α=0.05。结果： 1、动情周期的变化 B1组大鼠失去规律动情周期变化，分别出现了持续性动情期、动情间期、动情后期延长、无动情期等动情周期紊乱表现；B2组大鼠动情周期呈正常的规律性周期变化。 2、血清甲状腺素水平的比较 B1组与A组相比，TPO-Ab、TSH水平升高，FT4水平降低，比较差异均有统计学意义（P＜0.05）；B2组与B1组相比，TPO-Ab、TSH水平降低，FT4水平升高，比较差异均有统计学意义（P＜0.05）；B2组与A组相比，TPO-Ab、TSH、FT4水平比较差异无统计学意义（P＞0.05）。 3、生殖及妊娠结局的比较 B1组A组相比，不良结局的发病率升高，比较差异有统计学意义；B2组与B1组相比，不良结局的发病率降低；B2组与A组相比，不良结局发病率比较差异无统计学意义。 4、子鼠数目的比较 B1组与A相比，大鼠所产子鼠的数目降低（P＜0.05）；B2组与B1组相比，大鼠所产子鼠的数目升高（P＜0.05）；B2组与A相比，大鼠所产子鼠的数目差异无统计学意义（P＞0.05）。 5、B1组中有1只大鼠血压，且其仅娩出1只子鼠，该子鼠出生后行动迟缓，目光呆滞，并与当日死亡。结论： 1、甲状腺功能减退症可导致雌性大鼠动情周期紊乱；甲状腺功能减退症经左甲状腺素的有效治疗至雌鼠甲功正常后，，可使其动情周期恢复； 2、甲状腺功能减退症可导致不孕、妊娠期高血压病、自然流产等不良结局；甲状腺功能减退经左甲状腺素的有效治疗至雌鼠甲功正常后，可使其上述结局发生良性转归； 3、甲状腺功能减退症可能是导致子鼠低体重及围生期死亡的重要原因之一，孕前利用左甲状腺素的有效干预将有利于子代存活及生长发育。 4、孕前筛查甲状腺功能及甲状腺功能减退症孕前治疗是有必要的。
[Abstract]:Objective: To study the effect of pre-pregnancy intervention on the outcome of reproductive and pregnancy in rats, and to further confirm the need for early treatment of hypothyroidism. In order to provide a powerful basis for the study of the pre-pregnancy and the necessity of the treatment of hypothyroidism. Methods: Waxy female rats were randomly divided into normal control group (group A), hypothyroidism group (group B1), and hypothyroidism (group B2). The rat model of hypothyroidism was established by the method of il (PTU), and the group A was given intragastric administration. After the model was successful, the group B1 continued to give the PTU and the B2 group to the PTU and the left thyroxine (L-T4) was administered while the group A continued to tap water. The three groups of rat estrus cycles (corresponding to the human's menstrual cycle) were monitored by intragastric administration, vaginal cell smears, routine HE staining, and the like every morning after 4 weeks. The changes of the concentrations of FT4, TPO-Ab and TSH in the serum of each group were detected by the method of light-emission immunoassay. Analysis, to meet the positive and the homogeneity, the measurement data adopts the x s (mean square standard deviation) as the parameter, the inter-group comparison adopts t-test, and the test level is equal to 0. 05. The comparison between the counting data groups shall be 2 test, and the inspection level is equal to 0. 05. Results: 1. The change of the dynamic period of the rats in the first group and the change of the dynamic period of the rats in the group B1, respectively, showed a continuous period of estrus, an interval of dynamic emotion, an extension of the anaphase of the moestrus, no dynamic period, and the like, and the dynamic period of the rats in the B2 group. and the normal regular period is changed. 2. Compared with group A, the level of serum thyroxine increased, the level of TPO-Ab and TSH increased, and the level of FT4 was decreased, and the difference was significant (P <0.05). (b) The level of TSH decreased and the level of FT4 increased, and the difference was significant (P <0.05), and the level of TPO-Ab, TSH and FT4 was higher in group B2 than in group A. No significant difference (P> 0. 05). The incidence of adverse outcomes was increased compared with group A in group A compared with group A in group A, and the incidence of adverse outcomes was lower in group B2 compared to group B1; group B2 Bad knot as compared to Group A There was no significant difference in the incidence of mice. 4. The number of mice in group B was lower than that of group A (P <0.05), and the number of mice in group B2 was higher than that of group B (P <0.05); group B2 and group B were higher (P <0.05). There was no significant difference in the number of rats (P> 0.05). and it It was found that 1, hypothyroidism could lead to a disorder of estrus cycle in female rats.; hypothyroidism via levothyroxine can be used for effectively treating female rats, and can be used for recovery of estrus cycle; and 2, hypothyroidism can lead to adverse outcomes such as infertility, hypertension in pregnancy, spontaneous abortion, and the like.; A Hypothyroidism via levothyroxine can result in a positive outcome in the above-mentioned outcome after the effective treatment of levothyroxine to the female, and 3, hypothyroidism may be a result of the submouse One of the important causes of death in low body weight and perinatal period, and the effective method of using levothyroxine before pregnancy
【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】：R714.7

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