甲状腺自身抗体对甲状腺功能正常不孕女性辅助生殖结局的影响meta分析  

Influence of thyroid autoantibodies on outcomes of infertile euthyroid women undergoing assisted reproductive therapy:a meta analysis

作　　者：丁静雅 秦露丹 徐勇 周路平 蒋春霞 

机构地区：[1]西南医科大学附属医院内分泌科,四川泸州646000

出　　处：《现代医药卫生》2018年第2期189-193,197,共6页Journal of Modern Medicine & Health

摘　　要：目的研究甲状腺自身抗体(ATA)对甲状腺功能正常不孕女性辅助生殖(ATR)结局的影响。方法以"甲状腺自身抗体"和"辅助生殖"等为关键词在中国知网、维普网、Pubmed、Ovid、Embase数据库中进行检索,收集前瞻性研究;纳入ATA阳性的甲状腺功能正常的不孕女性;应用STATA12.0软件录入数据,并进行meta分析。结果经检索和筛选后共纳入7篇文献。分析结果显示,在前瞻性研究中ATA阳性的女性进行ATR时临床及生化妊娠率均不受影响;而流产率[相对风险(RR)=1.943,95%CI(1.422,2.665),P<0.001]与生产率[RR=0.693,95%CI(0.505,0.950),P=0.023]均受到ATA存在的影响。同时对于甲状腺过氧化物酶抗体(TPO)进行亚组分析发现,TPO抗体阳性的女性流产率与对照组相比明显增高[RR=2.318,95%CI(1.494,3.095),P<0.001];TPO抗体阳性的女性生产率与对照组相比降低[RR=0.634,95%CI(0.419,0.961),P=0.032]。结论在甲状腺功能正常的ATA阳性的不孕女性中,流产风险有所增加,而生产率有所降低。Objective To investigate the influence of thyroid autoantibodies（ATA）on the outcomes of infertile euthyroid women undergoing assisted reproductive therapy. Methods The databases of CNKI,VIP network,Pub Med,Ovid and Embase were retrieved with＂thyroid autoantibody＂and＂assisted reproduction＂as the key words for collecting the prospective studies. The euthyroid women with ATA positive were included;the STATA12.0 software was used to entry the data and conduct the meta analysis. Results Seven articles were included by retrieval and screening. The analysis results showed that the clinical and biochemical pregnancy rate of the ATA positive females in the prospective studies this studies was not affected during conducting ART;but the miscarriage rate（RR=1.943,95%CI（1.422,2.665）,P〈0.001）and delivery rate（RR=0.693,95%CI（0.505-0.950）,P=0.023）were influenced by the ATA existence. Meanwhile the subgroup analysis on thyroid peroxidase antibody（TPO）revealed that the miscarriage rate in TPO positive women was significantly increased when compared with the control group（RR=2.138,95%CI（1.494-3.059）,P〈0.001）,while the delivery rate in TPO positive women was decreased compared with the controlg roup（RR=0.634,95%CI（0.419-0.961）,P=0.032）. Conclusion In infertile euthyroid women with ATA positive,the miscarriage risk is increased and the delivery rate is decreased.

关 键 词：甲状腺 自身抗体 不育 女(雌)性 生殖技术 受精 体外 流产 过氧化物酶类 

分 类 号：R714.8[医药卫生—妇产科学]