妊娠期亚临床甲状腺功能减退血清TSH、FT4、TPO-Ab与母胎并发症的关系  

The Relationship Between Serum TSH,FT4,TPO-Ab in Pregnant Women with Subclinical Hypothyroidism and Maternal-fetal Complications

作　　者：代先琼 齐小雪[1] 聂敦利 杨青梅 任秀聪 DAI Xianqiong;QI Xiaoxue;NIE Dunli;YANG Qingmei;REN Xiucong(Department of Obstetrics and Gynecology,Chengdu Integrated Traditional Chinese and Western Medicine Hospital(Chengdu First People′s Hospital),Chengdu 610000,China)

机构地区：[1]成都市中西医结合医院(成都市第一人民医院)妇产科,四川成都610000

出　　处：《标记免疫分析与临床》2020年第2期305-309,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的分析妊娠期亚临床甲状腺功能减退孕妇血清促甲状腺素(TSH)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPO-Ab)与母胎并发症发生的关系。方法将122例妊娠期亚临床甲状腺功能减退孕妇作为亚临床甲减组,并选取同期于我院规律产检的甲状腺功能正常孕妇50例作为对照组,全部孕妇均已行TSH、FT4、TPO-Ab检测,亚临床甲减孕妇持续监测以上指标至分娩,亚临床甲减孕妇按TPO-Ab筛查结果分为阳性、阴性组,按治疗情况分为治疗与未治疗组,比较各组TSH、FT4、TPO-Ab检测结果,并对比各组妊娠结局、母胎并发症发生情况。结果亚临床甲减组TSH、TPO-Ab高于对照组(P<0.05),两组FT4比较差异无统计学意义(P>0.05);亚临床甲减TPO-Ab阳性组与阴性组孕妇初筛TSH、FT4水平比较差异无统计学意义(P>0.05);亚临床甲减孕妇复查治疗组TSH、TPO-Ab低于未治疗组(P<0.05);亚临床甲减组胎儿总并发症发生率高于对照组(P<0.05);亚临床甲减TPO-Ab阳性组孕妇胎儿宫内窘迫及胎儿总并发症发生率高于TPO-Ab阴性组(P<0.05);亚临床甲减组中接受治疗孕妇胎儿窘迫、母体总并发症、胎儿总并发症发生率低于未治疗组(P<0.05)。结论妊娠期亚临床甲减呈高TSH、TPO-Ab特点,FT4正常,亚临床甲减可能增加胎儿并发症发生风险,尤其合并TPO-Ab阳性孕妇胎儿宫内窘迫及胎儿总并发症发生风险高,经对症干预可降低母胎并发症发生风险。Objective To analyze relationship between serum thyroid stimulating hormone(TSH),free thyroid hormone(FT4),thyroid peroxidase antibody(TPO-Ab)in pregnant women with subclinical hypothyroidism(SCH)and maternal-fetal complications.Methods 122 pregnant women with SCH were selected as the SCH group,while 50 normal pregnant women with normal thyroid function who underwent regular production inspection in the hospital during the same period were selected as the control group.All subjects were tested for TSH,FT4 and TPO-Ab.These indexes in the SCH group were continuously monitored until delivery.Pregnant women in the SCH group were further divided into the positive group and negative group according to the screening result of TPO-Ab,also,according to the treatment action,they were divided into the treated group and the untreated group.The detection results of TSH,FT4 and TPO-A,as well as pregnancy outcomes and occurrence of maternal-fetal complications were compared among groups.Results TSH and TPO-Ab in the SCH group were higher than those in the control group(P<0.05).There was no significant difference in FT4 between the two groups(P>0.05).There was no significant difference in TSH or FT4 level between the SCH TPO-Ab positive group and negative group(P>0.05).TSH and TPO-Ab in the treatment group were lower than those in the non-treatment group(P<0.05).The total incidence of fetal complications in the SCH group was higher than that in the control group(P<0.05).The incidence of intrauterine distress and total incidence of fetal complications in the SCH TPO-Ab positive group were higher than those in the TPO-Ab negative group(P<0.05).The incidence of fetal distress,total maternal complications and total incidence of fetal complications in the SCH group were lower than those in the non-treatment group(P<0.05).Conclusion In pregnant women with SCH,TSH and TPO-Ab are increased,and FT4 is normal.SCH might increase the risk of fetal complications,especially for patients with positive TPO-Ab:incidence of intrauterine distress

关 键 词：亚临床甲状腺功能减退 妊娠 甲状腺激素 甲状腺过氧化物酶抗体 并发症 

分 类 号：R714.25[医药卫生—妇产科学]