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Objective To study the relationship between thyroid hormone level and 24h urine protein quanti-tation in patients with severe preeclampsia. Methods From August 2015 to October 2017,180 patients with severe preeclampsia who were treated in the Third People's Hospital of Qingdao were selected. The level of thyroid-stimula-ting hormone ( TSH) was detected by chemiluminescence particles immune method. According to the test results,the patients were divided into normal group (n=110,TSH=0. 3-3. 3mU/L) and hypothyroidism group (n=70,TSH>3. 3mU/L). Another 240 healthy pregnant women who admitted in the Third People's Hospital of Qingdao during the same period were selected as control group. The TSH,free triiodothyronine (FT3),free thyroxine (FT4) levels and 24h urine protein quantitation were compared among the three groups. The correlation between the level of thyroid hormone and 24h urine protein quantitation,the results of thyroid autoantibody in patients with severe preeclampsia were analyzed.Results The FT4,FT3 levels in the normal group were (11.92±2.54)pmol/L,(5.22 ±1.25)pmol/L, respectively,which in the hypothyroidism group were (9. 02 ± 1. 09) pmol/L,(3. 92 ± 1. 57) pmol/L,respectively, which were all lower than those in the control group (t=6. 657,16. 758,13. 221,18. 245,all P<0. 05),which in the hypothyroidism group were lower than those in the normal group (t=9. 031,6. 149,all P<0. 05). The TSH,24h urine protein quantitation levels in the normal group were (2. 56 ± 0. 86) mU/L,(66. 51 ± 18. 52) mg,respectively, which in the hypothyroidism group were (5. 87 ± 3. 02) mU/L,(79. 14 ± 12. 58) mg,respectively,which were all higher than those in the control group(t=2. 330,7. 197,16. 417,13. 335,all P<0. 05),which in the hypothyroidism group were higher than those in the normal group (t=10. 883,5. 014,all P<0. 05). There was positive correlation between serum TSH and 24h urine protein quantitation in patients with severe preeclampsia (r=0. 254,P=0. 001). There was negative correlation between FT4 and 24h urine protein quantitation (r= -0. 182,P=0. 025). There was no correlation between serum FT3 and 24h urine protein quantitation (r= -0. 080,P=0. 330). The positive rates of TPO Ab,TG Ab were 12. 86％,18. 57％ in hypothyroidism group,there were no statistically significant differences compared with 10. 91％,14. 55％ in the normal group (χ2 =0. 158,0. 513;P=0. 691,0. 474). Conclusion There is correlation between thyroid hormone levels and 24h urine protein quantitation in patients with severe preeclampsia. It has great significance for clinical treatment of severe preeclampsia by detecting the level of thyroid hormone.
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The thyroid is closely related to neurological diseases. Abnormal thyroid function may cause a series of metabolic-related central nervous system symptoms. Hyperthyroidism encephalopathy and hypothyroidism encephalopathy associated with thyroid dysfunction are rare in adults. Clinicians pay less attention to hyperthyroidism or hypothyroidism encephalopathy, which mainly present as mental and cognitive disorders, epileptic seizures, motor disorders and other nervous system symptoms as the first manifestation. These diseases are easily to be misdiagnosed. Hashimoto encephalopathy (HE) is a kind thyroid antibody-elevated and hormone-sensitive encephalopathy, has various clinical manifestations without specific auxiliary examination, and diagnosis can only be made by excluding other diseases. Whether "HE" is an independent disease remains controversial, as it is not clear whether thyroid auto-antibodies are specific to "HE" or the pathogenesis. Therefore, the present paper mainly focuses on the adult encephalopathy associated with abnormal thyroid function and thyroid antibody-associated encephalopathy.
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Objective To investigate the changes and related factors of maternal thyroid autoantibodies during early pregnancy. Methods Urinary iodine concentration( UIC) , serum thyroid stimulating hormone( TSH) , free thyroxine ( FT4 ) , thyroid-peroxidase antibody ( TPOAb ) , thyroglobulin antibody ( TgAb ) concentrations were determined in 7 190 women during early pregnancy in an iodine-sufficient region of China. Results The prevalence of TPOAb positivity and TgAb positivity were 8. 7% and 12. 0% respectively. The prevalence of overt hypothyroidism and subclinical hypothyroidism increased significantly in group of thyroid antibody positivity. The prevalence of TPOAb positivity and TgAb positivity presented a U-shaped curve, ranging from mild iodine deficiency to iodine excess, especially increased significantly in the group with UIC<100 μg/L. Conclusion Prevalence of thyroid antibodies positivity became higher during early pregnancy. The positive thyroid autoantibodies during pregnancy were significantly associated with maternal hypothyroidism. Both iodine excess and iodine deficiency are risk factors of positive thyroid antibodies.