【摘要】：目的：探討甲狀腺功能減退癥的孕前干預(yù)對大鼠生殖及妊娠結(jié)局的影響，進(jìn)一步證實(shí)甲狀腺功能減退癥早發(fā)現(xiàn)早治療的必要性，為臨床上育齡期婦女孕前甲功檢查及甲狀腺功能減退癥治療的必要性提供有力的依據(jù)。 方法：將wistar雌性大鼠隨機(jī)分為正常對照組（A組）、甲狀腺功能減退癥組（B1組）、甲狀腺功能減退癥干預(yù)組（B2組）；對B1、B2組通過持續(xù)給予丙硫氧嘧啶（propylthiouracil，PTU）灌胃的方法建立甲狀腺功能減退大鼠模型，同時A組給予自來水灌胃；建模成功后，B1組繼續(xù)給PTU、B2組在給PTU的同時給予左甲狀腺素（L-T4）干預(yù)、A組繼續(xù)自來水灌胃；4周之后每日清晨行陰道細(xì)胞涂片、常規(guī)HE染色等方法，分別監(jiān)測三組大鼠動情周期（相當(dāng)于人類的月經(jīng)周期）的改變。隨后令所有雌性大鼠同時與正常雄鼠合籠交配，；采用發(fā)光免疫法檢測各組大鼠血清中FT4、TPO-Ab、TSH的濃度變化；對比三組大鼠生殖、妊娠結(jié)局的不同；最后采用SPSS17.0統(tǒng)計軟件對實(shí)驗(yàn)數(shù)據(jù)進(jìn)行統(tǒng)計學(xué)分析，滿足正態(tài)性和方差齊性，計量資料采用x s（均數(shù)±標(biāo)準(zhǔn)差）作為參數(shù)，組間比較采用t檢驗(yàn)，檢驗(yàn)水準(zhǔn)α=0.05。計數(shù)資料組間比較采用2檢驗(yàn)，檢驗(yàn)水準(zhǔn)α=0.05。 結(jié)果： 1、動情周期的變化 B1組大鼠失去規(guī)律動情周期變化，分別出現(xiàn)了持續(xù)性動情期、動情間期、動情后期延長、無動情期等動情周期紊亂表現(xiàn)；B2組大鼠動情周期呈正常的規(guī)律性周期變化。 2、血清甲狀腺素水平的比較 B1組與A組相比，TPO-Ab、TSH水平升高，F(xiàn)T4水平降低，比較差異均有統(tǒng)計學(xué)意義（P＜0.05）；B2組與B1組相比，TPO-Ab、TSH水平降低，F(xiàn)T4水平升高，比較差異均有統(tǒng)計學(xué)意義（P＜0.05）；B2組與A組相比，TPO-Ab、TSH、FT4水平比較差異無統(tǒng)計學(xué)意義（P＞0.05）。 3、生殖及妊娠結(jié)局的比較 B1組A組相比，不良結(jié)局的發(fā)病率升高，比較差異有統(tǒng)計學(xué)意義；B2組與B1組相比，不良結(jié)局的發(fā)病率降低；B2組與A組相比，不良結(jié)局發(fā)病率比較差異無統(tǒng)計學(xué)意義。 4、子鼠數(shù)目的比較 B1組與A相比，大鼠所產(chǎn)子鼠的數(shù)目降低（P＜0.05）；B2組與B1組相比，大鼠所產(chǎn)子鼠的數(shù)目升高（P＜0.05）；B2組與A相比，大鼠所產(chǎn)子鼠的數(shù)目差異無統(tǒng)計學(xué)意義（P＞0.05）。 5、B1組中有1只大鼠血壓，且其僅娩出1只子鼠，該子鼠出生后行動遲緩，目光呆滯，并與當(dāng)日死亡。 結(jié)論： 1、甲狀腺功能減退癥可導(dǎo)致雌性大鼠動情周期紊亂；甲狀腺功能減退癥經(jīng)左甲狀腺素的有效治療至雌鼠甲功正常后，，可使其動情周期恢復(fù)； 2、甲狀腺功能減退癥可導(dǎo)致不孕、妊娠期高血壓病、自然流產(chǎn)等不良結(jié)局；甲狀腺功能減退經(jīng)左甲狀腺素的有效治療至雌鼠甲功正常后，可使其上述結(jié)局發(fā)生良性轉(zhuǎn)歸； 3、甲狀腺功能減退癥可能是導(dǎo)致子鼠低體重及圍生期死亡的重要原因之一，孕前利用左甲狀腺素的有效干預(yù)將有利于子代存活及生長發(fā)育。 4、孕前篩查甲狀腺功能及甲狀腺功能減退癥孕前治療是有必要的。
[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
【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】：R714.7

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