产后甲状腺炎发病危险因素的Logistic回归分析  

Logistic regression analysis of risk factors for postpartum thyroiditis morbidity

作　　者：何劭君 王力川[2] 马刚[3] HE Shaojun;WANG Lichuan;MA Gang(The First People′s Hospital of Nanning,Nanning 530022,Guangxi,China;Maternal and Child Care Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003,China;The People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区南宁市第一人民医院,南宁市530022 [2]广西壮族自治区妇幼保健院,南宁市530003 [3]广西壮族自治区人民医院,南宁市530021

出　　处：《内科》2020年第4期400-403,共4页Internal Medicine

基　　金：广西壮族自治区卫生和计划生育委员会科研项目(Z20180088)。

摘　　要：目的探讨产后甲状腺炎发病的危险因素,为预防疾病发生提供参考。方法选取2019年2月至2020年1月在广西壮族自治区妇幼保健院诊治的产后甲状腺炎患者作为病例组,共54例;按1∶1选取在同医院同期生产、年龄匹配的产妇54例作为对照组,要求无基础疾病、产后甲状腺功能正常。通过查阅病历,收集两组对象的临床资料,比较病例组患者和对照组产妇的甲状腺自身免疫抗体(TRAb,TPOAb,TgAb)、空腹血糖(FBG)、血脂、25-羟维生素D[25(OH)D]、体质量指数(BMI)水平;对产妇发生产后甲状腺炎的危险因素进行多因素Logistic回归分析。结果单因素分析结果显示,产后甲状腺炎患者的甲状腺过氧化物酶抗体(TPOAb)水平、甲状腺球蛋白抗体(TgAb)阳性率及25(OH)D不足/缺乏的发生率均显著高于对照组产妇,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,TgAb阳性、TPOAb阳性、25(OH)D不足/缺乏是产后甲状腺炎发生的危险因素。结论TgAb阳性、TPOAb阳性、25-羟维生素D不足/缺乏与产后甲状腺炎的发生密切相关,根据检测结果补充维生素D可能有助于预防产后甲状腺炎的发生。Objective To explore the risk factors for postpartum thyroiditis morbidity,and to provide references for preventing the occurrence of disease.Methods A total of 54 patients with postpartum thyroiditis who were diagnosed and treated in the Maternal and Child Care Hospital of Guangxi Zhuang Autonomous Region from February 2019 to January 2020 were selected as the case group.According to 1∶1,54 puerpera with matched age having parturition at the same time in the same hospital,who were required to have no underlying diseases,and postpartum thyroid function were normal,were selected as control group.Collecting clinical data of the two groups by reviewing the medical records.The levels of thyroid autoimmune antibodies(TRAb,TPOAb,TgAb),fasting blood glucose(FBG),blood lipids,25-hydroxyvitamin D[25(OH)D],body mass index(BMI)were compared between the case group and the control group.Multivariate logistic regression analysis was performed on the risk factors for postpartum thyroiditis.Results The univariate analysis results showed that the thyroid peroxidase antibody(TPOAb)level,the positive rate of thyroglobulin antibody(TgAb),and the incidence of 25(OH)D insufficiency/deficiency in patients with postpartum thyroiditis were significantly higher than those of the control group,following statistically significant differences(P<0.05).Multivariate logistic regression analysis results showed that TgAb positive,TPOAb positive,and 25(OH)D insufficiency/deficiency were risk factors for the occurrence of postpartum thyroiditis.Conclusion TgAb positive,TPOAb positive,and 25(OH)D insufficiency/deficiency are closely related to the occurrence of postpartum thyroiditis.Supplementing vitamin D according to the test results may help to prevent the occurrence of postpartum thyroiditis.

关 键 词：产后甲状腺炎 自身免疫性炎症 25-羟维生素D 甲状腺过氧化物酶抗体(TPOAb) 甲状腺球蛋白抗体(TgAb) 

分 类 号：R581.4[医药卫生—内分泌]