妊娠妇女甲状腺自身抗体与甲状腺功能减退的关系  

Study on the relationship between thyroid autoantibodies and hypothyroidism in pregnant women

作　　者：魏粤晓 王吉云 陈童真 

机构地区：[1]河北省沧州市人民医院产科,河北沧州061001

出　　处：《中国医药导报》2016年第23期94-97,共4页China Medical Herald

基　　金：河北省沧州市科学技术局项目(151302073)

摘　　要：目的探讨沧州地区妊娠妇女血清甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TGAb）的阳性率及其与甲状腺功能减退的关系。方法选取2013年8月～2014年12月在沧州市人民医院产科门诊进行产前检查的妊娠妇女786例，按孕龄分为T1、T2、T3期，采用电化学免疫分析法测定其血清促甲状腺素（TSH）、游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）及TPOAb、TGAb水平。根据《妊娠和产后甲状腺疾病诊治指南》规定的标准，将妊娠妇女分为甲功正常组、临床甲减组、亚临床甲减组和低甲状腺素（rr4）血症组。观察比较不同分组和分期孕妇TPOAb、TGAb的阳性率。结果妊娠妇女在T1、T2、T3期TPOAb阳性率分别为9．95％、11．07％、11．22％，TGAb的阳性率分别为8．14％、9．09％、8．65％。甲功正常组、临床甲减组、亚临床甲减组、低T4血症组TPOAb阳性率分别为8．03％、77．78％、53．57％、28．57％，临床甲减组、亚临床甲减组与甲功正常组比较差异均有统计学意义（P〈0．05），低T4血症组与甲功正常组比较差异无统计学意义（P〉0．05）；TGAb的阳性率分别为8．30％、33．33％、10．71％、7．14％，各组比较差异无统计学意义（P〉0．05）。结论甲状腺功能紊乱的孕妇甲状腺自身抗体检出率高，TPOAb、TGAb阳性可作为评估妊娠期妇女甲状腺功能减退的指标。Objective To discuss the positive rate of serum thyroid peroxidase antibody （TPOAb） and thyroglohulin an- tibody （TGAb） and the relationship with hypothyroidism in pregnant women in Cangzhou area. Methods From August 2013 to December 2014, 786 pregnant women received antenatal examination in Cangzhou People＇s Hospital of the Department of Obstetrics Outpatient were sselected, and they were divided into T1 period, T2 period and Ta period accord- ing to the gestafional week. The serum levels of thyroid stimulating hormone （TSH）, free thyroxin （FT4） free triiodothyro- nine （FT3）, TPOAb and TGAb were determined by electrochemical immunoassay. In accordance with ＂guidelines for the diagnosis and treatment of thyroid disease in pregnancy and postpartum＂, the pregnant women were divided into euthyroid group, clinical hypothyroidism group, subclinical hypothyroidism group and hypothyroxinemia group. Positive rate of TPOAb, TGAb of pregnant women in different groups and period were compared. Results Positive rate of TPOAb of pregnancy women in the Th T2, T3 period were 9.95%, 11.07% and 11.22% respectively, while positive rate of TGAb were 8.14%, 9.09% and 8.65% respectively; TPOAb positive rate of the euthyroid group, clinical hypothyroidism group, subclinical hypothyroidism group and hypothyroxinemia group were 8.03%e, 77.78%, 53.57% and 28.57% respectively, comparison of the clinical hypothyroidism group, subclinical hypothyroidism and the normal thyroid function group was statistically significant （P 〈 0.05）, there was no significant difference between the normal group and the hypothyroxinemia group （P 〉 0.05）. The positive rates of TGAb of the clinical hypothyroidism group, subclinical hypothyroidism and the normal thyroid function group were 8.30%, 33.33%, 10.71% and 7.14% respectively, there was no significant difference between the four groups （P 〉 0.05）. Conclusion The detection rate of thyroid autoantibodies in pregnant women with thyroid dysfunction is high, and the p

关 键 词：甲状腺功能减退 甲状腺过氧化物酶抗体 甲状腺球蛋白抗体 

分 类 号：R581.4[医药卫生—内分泌]