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JCEM：hCG+甲状腺功能，能否预测子痫前期风险？

2016-09-26 Moon 译 MedSci原创

hCG甲状腺功能子痫前期
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在怀孕期间，对甲状腺激素的需求有所增加。妊娠时产生的人绒毛膜促性腺激素（HCG）是甲状腺功能的重要生理刺激。已有研究表明，母亲T4浓度位于正常高限时，子痫前期风险也会变高。 我们研究的假设为：根据HCG浓度可以区分高甲状腺功能的生理形式、高甲状腺功能的病理形式，以及这两种不同形式下的子痫前期风险也会是不同的。 这项以人群为基础的前瞻性队列研究，检测了5146名孕妇的TSH、FT4、hC

在怀孕期间，对甲状腺激素的需求有所增加。妊娠时产生的人绒毛膜促性腺激素（HCG）是甲状腺功能的重要生理刺激。已有研究表明，母亲T4浓度位于正常高限时，子痫前期风险也会变高。

我们研究的假设为：根据HCG浓度可以区分高甲状腺功能的生理形式、高甲状腺功能的病理形式，以及这两种不同形式下的子痫前期风险也会是不同的。

这项以人群为基础的前瞻性队列研究，检测了5146名孕妇的TSH、FT4、hCG或TPO-抗体水平。

结果显示，高hCG+高甲状腺功能孕妇，与正常甲状腺功能的孕妇相比，子痫前期风险并没有变得更高；但是低hCG+高甲状腺功能孕妇，与正常甲状腺功能的孕妇相比，子痫前期风险高出3.4-11.1倍。这些风险估计在高BMI女性中被放大。低HCG+TSH抑制(<0.10 mU/L)的孕妇，子痫前期风险高出3.2-8.9倍。hCG与子痫前期无关；TPO抗体阳性的女性排除后，结果仍然相同。

这项研究表明，与高hCG+高甲状腺功能孕妇相比，低hCG+高甲状腺功能孕妇有更高的子痫前期风险。因此，检测hCG可以帮助区分当下的稿甲状腺功能是生理上的还是病理上的，根据不同hCG浓度，还能判断孕妇子痫前期风险。

原始出处：

Korevaar TI.et al.The risk of pre-eclampsia according to high thyroid function in pregnancy differs by hCG concentration.J Clin Endocrinol Metab. 2016 Sep 20:jc20162397. [Epub ahead of print]

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createdBy=2a4439169927, createdName=smallant2015, createdTime=Wed Apr 19 12:18:00 CST 2017, time=2017-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144836, encodeId=b375144836ce, content=总结的很好！, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Tue Oct 11 17:23:00 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144834, encodeId=808214483470, content=分享一下！, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, 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    2016-11-22 achengzhao

    #JCE#

    0

  2. 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content=谢谢分享，，，, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 27 14:48:52 CST 2016, time=2016-09-27, status=1, ipAttribution=)]
    2017-04-19 smallant2015

    #JCEM#

    0

  3. 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content=谢谢分享，，，, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 27 14:48:52 CST 2016, time=2016-09-27, status=1, ipAttribution=)]
    2016-10-11 1e0d99ddm02(暂无匿称)

    总结的很好！

    0

  4. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8552, encryptionId=04f98552df, topicName=hCG)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ec053077747, createdName=zgwhgch, createdTime=Wed Sep 28 11:18:00 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=136024, encodeId=72b113602408, content=很不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 27 14:49:01 CST 2016, time=2016-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=136023, encodeId=83ac13602356, content=谢谢分享，，，, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 27 14:48:52 CST 2016, time=2016-09-27, status=1, ipAttribution=)]
    2016-10-11 1e0d99ddm02(暂无匿称)

    分享一下！

    0

  5. 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content=谢谢分享，，，, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 27 14:48:52 CST 2016, time=2016-09-27, status=1, ipAttribution=)]
    2016-10-01 doctorJiangchao

    继续关注

    0

  6. 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content=谢谢分享，，，, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 27 14:48:52 CST 2016, time=2016-09-27, status=1, ipAttribution=)]
    2016-10-01 doctorJiangchao

    继续学习

    0

  7. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8552, encryptionId=04f98552df, topicName=hCG)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ec053077747, createdName=zgwhgch, createdTime=Wed Sep 28 11:18:00 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=136024, encodeId=72b113602408, content=很不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 27 14:49:01 CST 2016, time=2016-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=136023, encodeId=83ac13602356, content=谢谢分享，，，, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 27 14:48:52 CST 2016, time=2016-09-27, status=1, ipAttribution=)]
    2016-09-28 yahu

    #子痫前期#

    0

  8. 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content=谢谢分享，，，, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 27 14:48:52 CST 2016, time=2016-09-27, status=1, ipAttribution=)]
    2016-09-28 zgwhgch

    #hCG#

    0

  9. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8552, encryptionId=04f98552df, topicName=hCG)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ec053077747, createdName=zgwhgch, createdTime=Wed Sep 28 11:18:00 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=136024, encodeId=72b113602408, content=很不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 27 14:49:01 CST 2016, time=2016-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=136023, encodeId=83ac13602356, content=谢谢分享，，，, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 27 14:48:52 CST 2016, time=2016-09-27, status=1, ipAttribution=)]
    2016-09-27 医路开来

    很不错的文章

    0

  10. 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content=谢谢分享，，，, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Tue Sep 27 14:48:52 CST 2016, time=2016-09-27, status=1, ipAttribution=)]
    2016-09-27 医路开来

    谢谢分享，，，

    0

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背景：先兆流产影响1/5的女性，它与情绪困扰有显著相关性。先兆流产的预后仍然不能确定，由此成为了医疗护理专业人员的一项挑战。过去几年已经研究出多种生物标志物以预测先兆流产的结局；然而，结果却十分矛盾。因此，研究人员构建了一项系统性回顾性meta分析，以研究生物标志物在预测先兆流产女性妊娠结局的诊断准确性。方法：这是一项系统回顾性meta分析的前瞻性研究，探究生物标志物预测孕龄在5-23周范围的女性

Lancet：葡萄胎后hCG升高不一定提示恶性

11月28日在线发表于《柳叶刀》杂志(Lancet)的一项大型回顾性队列研究显示，如果在葡萄胎清宫后6个月绒毛膜促性腺激素(hCG)水平仍高于正常但正处于下降过程中，则不需要化疗，因为几乎所有此类患者的hCG都将自行恢复正常(doi:10.1016/S0140-6736[11]61265-8)。 当前的国际临床指南认为，葡萄胎清宫后³6个月hCG水平仍高于正常是化疗的指征(Int. J

早孕时期hCG检测助于子痫前期风险预测

那些怀孕与甲状腺功能间牵扯不清的事众所周知，判断女性是否怀孕可以通过血hCG（人绒毛促性腺激素）检查来确定。hCG是在女性妊娠后自然升高的一种胎盘类激素，由于hCG分子跟TSH（促甲状腺激素）分子结构具有相似性，早在上世纪70年代就有实验证明hCG对甲状腺具有刺激作用。因此，在早孕时期由于hCG的快速增长，会导致血清甲状腺激素的升高，而TSH则会受到抑制。当然，滋养细胞疾病也会导致hCG分泌的大量