妊娠早期妇女甲状腺自身抗体分析  

The analysis of the changes of maternal thyroid autoantibodies during early pregnancy

作　　者：史晓光[1] 韩成[1] 李晨嫣[1] 毛金媛[1] 王薇薇[1] 解晓晨[1] 周卫卫[3] 李晨阳 毕丽华[5] 孟涛[2] 张绍维[6] 杜建玲[7] 高政南[8] 张晓梅 范晨玲[1] 单忠艳[1] 滕卫平[1] 

机构地区：[1]中国医科大学附属第一医院内分泌科,沈阳110001 [2]中国医科大学附属第一医院妇产科,沈阳110001 [3]沈阳市妇婴医院妇产科,110014 [4]沈阳市妇幼保健院妇产科,110031 [5]大连市妇产医院妇产科,116033 [6]中国人民解放军第202医院内分泌科张绍维,沈阳110003 [7]大连医科大学附属第一医院内分泌科,116011 [8]大连市中心医院内分泌科,116033 [9]丹东市第一医院内分泌科,118000

出　　处：《中华内分泌代谢杂志》2016年第5期376-379,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：国家科技部十二五支撑计划（2014BA106802）;辽宁省高等学校创新团队基金（LT2012015）;沈阳市重点实验室建设基金（F11-244-1-00）;辽宁省重点实验室建设基金（2011225023）;国家光华科技基金会（2007-02）

摘　　要：目的：分析妊娠早期妇女甲状腺自身抗体变化和相关因素。方法碘充足地区妊娠早期妇女7190例,测定尿碘浓度（ UIC）,血清促甲状腺激素（ TSH）,游离甲状腺素（ FT4）,甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TgAb）。结果 TPOAb和TgAb的阳性率分别为8.7%和12.0%。甲状腺抗体阳性组临床甲减和亚临床甲减的患病率显著增高。甲状腺抗体的阳性率与UIC呈现U型关系,即碘摄入量的增加和减少都与抗体的阳性率增高相关,特别是在碘缺乏（ UIC〈100μg/L）时,TPOAb和TgAb阳性率增高更加明显。结论妊娠期甲状腺抗体阳性与孕妇的甲状腺功能减退相关。碘过量、碘缺乏都是孕妇甲状腺抗体阳性率显著增加的危险因素。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.

关 键 词：甲状腺 妊娠 甲状腺抗体 碘 

分 类 号：R714.256[医药卫生—妇产科学]