本文關(guān)鍵詞： 孕鼠 甲狀腺功能減退 自然流產(chǎn) 左旋甲狀腺素治療　出處：《山西醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的甲狀腺功能減退癥是由多種原因?qū)е碌牡图谞钕偌に匮Y或甲狀腺激素抵抗而引起的全身性低代謝性綜合征，是由于甲狀腺激素合成和分泌減少或組織利用不足所致。妊娠期間，隨著母體甲狀腺結(jié)構(gòu)和分泌激素功能的改變，更容易導(dǎo)致甲狀腺功能異常，臨床上以甲狀腺功能減退多見。甲狀腺功能減退易引發(fā)不孕、自然流產(chǎn)、死胎、妊娠期高血壓、早產(chǎn)、產(chǎn)后出血等不良妊娠結(jié)局，其對母兒的危害已引起國內(nèi)外圍產(chǎn)醫(yī)學(xué)、內(nèi)分泌學(xué)者的廣泛關(guān)注。目前國內(nèi)外研究一致認(rèn)為在確定妊娠期甲狀腺功能減退后，經(jīng)及時足量使用左旋甲狀腺素替代治療，可改善不良妊娠結(jié)局。本研究旨在探討經(jīng)過左旋甲狀腺素干預(yù)后的甲狀腺功能減退癥孕鼠自然流產(chǎn)的狀況。 方法將80只雌性大鼠隨機(jī)取20只作為正常對照組，余60只利用丙硫氧嘧啶灌胃法創(chuàng)建甲狀腺功能減退癥大鼠模型，后隨機(jī)分為兩組：甲減組30只，甲減治療組30只；甲減組繼續(xù)給予丙硫氧嘧啶（PTU），甲減治療組在給PTU的同時，給予L-T4干預(yù)；4周后觀察各組動情周期；合籠前靜脈采血，并用酶聯(lián)免疫吸附實(shí)驗(yàn)（Elisa法）測定大鼠血清中FT4、TSH、TPO-Ab濃度，比較各組激素水平；合籠后觀察所有大鼠的妊娠結(jié)局，統(tǒng)計(jì)各組所產(chǎn)的仔鼠數(shù)量。統(tǒng)計(jì)學(xué)方法采用SPSS17.0統(tǒng)計(jì)分析軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。滿足正態(tài)性和方差齊性，，統(tǒng)計(jì)學(xué)處理以均數(shù)加減標(biāo)準(zhǔn)差表示，計(jì)量資料采用t檢驗(yàn)，計(jì)數(shù)資料采用χ2檢驗(yàn)，檢驗(yàn)水準(zhǔn)α=0.05。 結(jié)果光鏡下顯示患有甲狀腺功能減退癥的大鼠動情周期紊亂。甲減組與甲減治療組相比FT4水平較低，TSH偏高，TPO-Ab偏高，均有顯著性差異（P＜0.05）；甲減治療組與正常對照組相比三種激素水平無顯著性差異（P＞0.05）；正常對照組與甲減組相比，前者仔鼠數(shù)量多于后者,有顯著性差異（P＜0.05）；甲減治療組與正常對照組仔鼠數(shù)量相比無顯著性差異（P＞0.05）。 結(jié)論1.甲狀腺功能減退癥可致動情周期紊亂； 2.甲狀腺功能減退癥是導(dǎo)致自然流產(chǎn)的因素之一； 3.通過左旋甲狀腺素替代治療，可明顯減少甲狀腺功能減退癥孕鼠自然流產(chǎn)的發(fā)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 偽 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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R714.21

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