早期自然流产患者高密度脂蛋白功能变化及其与甲状腺自身免疫关系研究  

Functional change of high-density lipoprotein in early spontaneous abortions and its association with thyriod autoimmunity

作　　者：李园美[1] 张倩[1] 赵慧栋[1] 徐风森[1] 

机构地区：[1]青岛市市立医院产科,山东青岛266011

出　　处：《中国实用妇科与产科杂志》2015年第9期857-860,共4页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨早期自然流产患者高密度脂蛋白(HDL)功能的改变及其与甲状腺自身免疫的关系。方法随访2012年3月至2014年9月青岛市市立医院妊娠妇女至妊娠14周、甲状腺功能正常的早期自然流产者68例(流产组),进一步依据甲状腺过氧化物酶抗体(TPO-Ab)分为TPO-Ab(+)组(23例)和TPO-Ab(-)组(45例);选取同期甲状腺功能正常的未流产者20例为对照组。超高速密度梯度离心法分离HDL。通过检测对氧磷酶-1(PON-1)活性判定HDL的抗氧化功能;通过检测血清淀粉样蛋白A(SAA)含量判定HDL的抗炎状态,并检测HDL介导的巨噬细胞胆固醇流出率。结果流产组TPO-Ab阳性率显著高于未流产组,差异有统计学意义(χ2=28.16,P=0.000)。TPO-Ab(+)组PON-1、胆固醇外流率均低于TPO-Ab(-)组及对照组,差异有统计学意义(均P<0.01);TPO-Ab(+)组SAA水平高于TPO-Ab(-)组及对照组,差异有统计学意义(P<0.01);TPO-Ab(-)组HDL各项功能指标与对照组差异无统计学意义。TPO-Ab(+)组HDL功能指标与TPO-Ab滴度无相关性(P>0.01)。结论甲状腺自身免疫使早期自然流产患者的HDL功能受损;功能异常的HDL可能参与了早期自然流产的发病。Objective To explore the functional change of high-density lipoprotein in early spontaneous abortions and its association with thyriod autoimmune. Methods A follow-up study was performed from March, 2012 to September,2014 on 571 women in the first trimester of pregnancy who visited Qingdao Municipal Hospital. 68 euthyriod pregnant women diagnosed spontaneous abortion were enrolled as the study group, and was further divided to TPO-Ab（＋） group and TPO-Ab（-） group.Twenty euthyroid healthy ones were enrolled as the control group.The HDL fraction was separated with speed density gradient centrifugation. Paraoxonase-1（PON-1） activity and serum amyloid A protein（SAA） were measured to determine antioxidation capacity and inflammatory response of HDL respectively. HDL-mediated cholesterol efflux from macrophages was also detected. The data was analyzed by SPSS17.0. Results About 27.4% of women with abortions had positive TPO-Ab compared with 6.8% of those healthy ones. While comparing the three groups, statistically lower levels were shown in PON-1 and HDL-mediated cholesterol efflux in TPO-Ab（＋） group than in TPO-Ab（-）group and control group（P=0.000）. SAA level was higher in TPO-Ab（＋） group than that in TPO-Ab（-） group and control group（P=0.000）.There were no significant differences of those above between TPO-Ab（-） group and control group（P〉0.01）. The indcators of HDL functions in TPO-Ab（＋） group demonstrated no correlations with TPO-Ab titers（P〉0.01）.Conclusions Thyriod autoimmune can cause functional changes in HDL, and the impaired HDL particlesmay participate in the pathogenesis of early spontaneous abortion.

关 键 词：甲状腺自身免疫 早期自然流产 高密度脂蛋白 

分 类 号：R714.256[医药卫生—妇产科学]