妊娠亚临床甲减患者血清TSH、TPO-AB水平与妊娠结局的相关性研究  

The Correlation Between Serum TSH and TPO-AB Levels and Pregnancy Outcomes in Patients with Gestational Subclinical Hypothyroidism

作　　者：高原[1] 万明[1] 王家丽 姚婷[1] 刘敏[1] 任波 孙秋 唐诗 陈晓敏 谌黎 GAO Yuan;WAN Ming;WANG Jiali;YAO Ting;LIU Min;REN Bo;SUN Qiu;TANG Shi;CHEN Xiao-min;SHEN Li(Department of Endocrinology,416 Hospital of Nuclear Industry(the Second Affiliated Hospital of ChengduMedical College),Chengdu 610051,China)

机构地区：[1]核工业四一六医院(成都医学院附属第二医院)内分泌科,四川成都610051

出　　处：《标记免疫分析与临床》2020年第2期267-270,共4页Labeled Immunoassays and Clinical Medicine

基　　金：成都医学院科研基金(编号:FYZX17012)。

摘　　要：目的探讨妊娠期合并亚临床甲状腺功能减退(亚甲减)患者血清促进甲状腺素(TSH),甲状腺过氧化物酶抗体(TPOAb)水平与妊娠结局的关系。方法选取2016年1月至2017年2月在我院定期接受产前检查、定期围产保健且住院分娩的亚甲减患者300例,根据有无接受治疗分为亚甲减治疗组(n=189)和亚甲减未治疗组(n=111);根据血清TSH中位数水平分为高TSH水平组(n=95)和低TSH水平组(n=205);并根据血清TPOAb检测是否为阳性分为TPOAb阳性组(n=182)与TPOAb阴性组(n=118)。另选取同期300例健康孕妇为对照组。对各组妊娠结局进行统计分析。结果亚甲减未治疗组流产、早产、GDM、妊娠期高血压疾病、胎儿生长受限、低出生体重儿发生率均明显高于亚甲减治疗组及对照组(P<0.05)。亚甲减孕妇中,高TSH水平组流产、早产、GDM、妊娠期高血压疾病、胎儿生长受限、低出生体重儿发生率均明显高于低TSH水平组(P<0.05);TPOAb阳性组流产、早产、GDM、妊娠期高血压疾病、低出生体重儿发生率均明显高于TPOAb阴性组(P<0.05)。结论妊娠合并亚甲减可增加流产、早产、GDM、妊娠期高血压疾病、胎儿生长受限、低出生体重儿发生率,且血清TSH水平越高及TPOAb阳性,不良妊娠结局风险越高。Objective To investigate the relationship between serum thyroid stimulating hormone(TSH)and thyroid peroxidase antibody(TPOAb)levels and pregnancy outcomes in patients with gestational subclinical hypothyroidism(SCH).Methods 300 patients with SCH who received regular antenatal care,regular perinatal care and hospitalized delivery in the hospital from January,2016 to February,2017 were selected for the study.They were divided into the treated group(n=189)and the untreated group(n=111)according to the application of treatment.According to the median level of serum TSH,the patients were divided into the high TSH level group(n=95)and the low TSH level group(n=205).According to the detection results of serum TPOAb,the patients were divided into TPOAb positive group(n=182)and TPOAb negative group(n=118).300 healthy pregnant women were selected as the control group.Pregnancy outcomes of each group were statistically analyzed.Results The incidence rates of abortion,premature delivery,GDM,hypertensive disorder complicating pregnancy,fetal growth restriction and low birth weight infants were significantly higher in the untreated group than in the treated group and the control group,also significantly higher in the high TSH level group than in the low TSH level group,and significantly higher in TPOAb positive group than in TPOAb negative group(all P<0.05).Conclusion Pregnancy with SCH can increase the incidence rates of abortion,premature delivery,GDM,hypertensive disorder complicating pregnancy,fetal growth restriction and low birth weight infants.The higher the serum TSH level is with TPOAb positive,the higher the risk of adverse pregnancy outcomes is.

关 键 词：妊娠 亚临床甲状腺功能减退 甲状腺过氧化物酶抗体 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]