妊娠期甲状腺功能减退与子痫前期发病的相关性探讨  

Relationship between Hypothyroidism during Pregnancy and the Incidence of Preeclampsia

作　　者：郭雪晶 马梓汶 黄鹰[1] 丁晓颖[1] GUO Xuejing;MA Ziwen;HUANG Ying;DING Xiaoying(Department of Obstetrics and Gynecology,Shanghai Pudong New Area Maternal and Child Health Hospital,Shanghai 201206,China)

机构地区：[1]上海市浦东新区妇幼保健院妇产科

出　　处：《中国医药导刊》2019年第9期538-542,共5页Chinese Journal of Medicinal Guide

基　　金：浦东新区卫生系统优秀青年医学人才培养计划(项目编号:PWRq2016-37)

摘　　要：目的:探讨妊娠期甲状腺功能减退孕妇甲状腺激素水平、甲状腺抗体指标与子痫前期发病的关系。方法:选取2017年1月至2018年6月在我院产科门诊定期产检并住院待产的妊娠期甲状腺功能减退孕妇130例为甲减组,同期选取孕周与甲减组相匹配的孕妇193例作为对照组。采用化学发光微粒免疫分析技术检测各组孕妇孕早期(12~14周)血清中促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT 3)、游离甲状腺素(FT 4)水平,采用化学发光法检测甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、甲状腺受体抗体(TRAb)水平,并计算阳性率(TPOAb>5.61 IU·mL^-1为阳性),同时追踪其妊娠结局,对甲减组及对照组孕妇血清甲状腺功能及抗体指标与子痫前期发病的相关性进行分析。结果:甲减组与对照组孕妇孕早期血清TSH、TPOAb的表达以及子痫前期发病率比较,其差异均具有统计学意义(P<0.05)。当TSH≥2.5 mIU·L^-1,子痫前期的发病率差异具有统计学意义(P<0.05),与TPOAb抗体表达的阳性与否无关。结论:当孕妇出现TSH≥2.5 mIU·L^-1的时候,无论其TPOAb阳性与否,其子痫前期的发病率均有所增加。Objective:To investigate the relationship between thyroid hormone levels,thyroid antibody levels and preeclampsia in patients with hypothyroidism during pregnancy.Methods:130 patients,from January 2017 to June 2018,who diagnosed as hypothyroidism during pregnancy in the department of obstetrics and gynecology of our hospital were divided into the hypothyroidism group.Matched 193 pregnant women were selected as the control group at the same period.Chemoluminescence microparticle immunoassay was used to detect the levels of serum thyroid stimulating hormone(TSH),free triiodothyronine(FT 3)and free thyroxine(FT 4)in the early pregnancy(12-14 weeks).The levels of anti-thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb)and thyroid receptor antibody(TRAb)were detected by chemiluminescence method,and the positive rate was calculated(TPOAb>5.61 IU·mL^-1 as positive).To track the pregnancy outcome,analyze the correlation between serum thyroid function、antibody indicators and preeclampsia incidence in patients in the hypothyroidism group and the control group.Results:The expression of serum THS,TPOAb in the first trimester and the incidence of preeclampsia of the hypothyroidism group and the control group have statistic difference(P<0.05).When TSH≥2.5 mIU·L^-1,the difference of incidence of preeclampsia was statistically significant(P<0.05),which was not related to the positive expression of TPOAb antibody.Conclusion:TSH≥2.5 mIU·L^-1 shows us a signal the incidence of preeclampsia increased,no matter the TPOAb positive or not.

关 键 词：妊娠期甲状腺功能减退 子痫前期 促甲状腺素 甲状腺过氧化物酶 

分 类 号：R714[医药卫生—妇产科学]