甲功五项联合TPOAb、TRAb检测在妊娠期妇女中的应用价值  

Application Values of Five Items of Thyroid Function Combined with TPOAb and TRAb in Pregnant Women

作　　者：景艳辉 向瑛[1] 谢睦星 JING Yanhui;XIANG Ying;XIE Muxing(Department of Obstetrics, Mianyang Maternal and Child Health Hospital, Mianyang Children’s Hospital, Mianyang 621000, China)

机构地区：[1]绵阳市妇幼保健院绵阳市儿童医院产科,四川绵阳621000

出　　处：《标记免疫分析与临床》2021年第6期997-1001,共5页Labeled Immunoassays and Clinical Medicine

基　　金：绵阳市社会心理服务体系建设试点创新项目(编号:20XL05)。

摘　　要：目的探究甲功五项联合甲状腺过氧化物酶抗体(TPOAb)、促甲状腺素受体抗体(TRAb)检测在妊娠期妇女中的应用价值。方法选择2019年7月至2021年2月于我院孕检并分娩的104例孕妇,均进行甲状腺功能筛查,检测甲功五项血清三碘甲状腺氨酸(T3)、甲状腺素(T4)、游离T3(FT3)、游离T4(FT4)、促甲状腺素(TSH)和TPOAb、TRAb水平,分析检测结果及孕妇妊娠结局。结果104例孕妇存在甲状腺功能异常的发生率为17.31%,TPOAb阳性率和TRAb阳性分别为15.38%、2.88%,妊娠早期、中期、晚期甲状腺功能异常发生率分别为11.54%、5.77%和0.00%,且妊娠早期甲状腺功能异常以TPOAb阳性、临床亚甲减和低T4血症为主,妊娠中期以TPOAb阳性、临床亚甲减为主;妊娠早期,TPOAb阳性、TRAb阳性孕妇TSH异常率均高于对应的阴性孕妇(P<0.05);妊娠中期TSH异常率比较差异无统计学意义(P>0.05);甲状腺功能异常孕妇的妊娠高血压、妊娠期糖尿病、妊娠期贫血、剖宫产、产后出血、胎盘早剥、胎膜早破、流产的概率及其娩出新生儿出现早产、新生儿窒息、胎儿窘迫、低体重、畸胎的概率均显著高于甲状腺功能正常孕妇(P<0.05)。结论妊娠期妇女甲状腺功能异常对其妊娠结局及新生儿结局均存在不良影响,临床联合检测甲功五项及TPOAb、TRAb水平评价妊娠期妇女甲状腺功能状态对母婴健康具有重要意义。Objective To explore the application values of five items of thyroid function combined with thyroid peroxidase antibody(TPOAb)and thyrotropin receptor antibody(TRAb)in pregnant women.Methods A total of 104 pregnant women who had pregnancy test and gave birth in our hospital from July,2019 to February,2021 were selected for thyroid function screening,and the five items of thyroid function of serum triiodothyronine(T3),thyroxine(T4),free T3(FT3),free T4(FT4)and thyroid stimulating hormone(TSH)and TPOAb and TRAb were detected in these patients.The detection results and pregnancy outcomes of pregnant women were then analyzed.Results The incidence rate of thyroid dysfunction was 17.31%among 104 pregnant women.The positive rates of TPOAb and TRAb were 15.38%and 2.88%,respectively.The incidence rates of thyroid dysfunction in the first,second and third trimesters of pregnancy were 11.54%,5.77%and 0.00%,respectively.Thyroid dysfunction status was as following:mainly positive for TPOAb,subclinical hypothyroidism and low T4emia in the first trimester of pregnancy,and mainly positive for TPOAb and subclinical hypothyroidism in the second trimester of pregnancy.In the first trimester of pregnancy,the abnormal rate of TSH of pregnant women with positive TPOAb and positive TRAb was higher than that of the corresponding negative pregnant women(P<0.05).There was no significant difference in the abnormal rate of TSH in the second trimester of pregnancy(P>0.05).The probabilities of pregnancy-induced hypertension,gestational diabetes mellitus,gestational anemia,cesarean section,postpartum hemorrhage,placental abruption,premature rupture of membranes and miscarriage and the probabilities of premature birth,neonatal asphyxia,fetal distress,low weight and teratogenesis of neonates of pregnant women with thyroid dysfunction were significantly higher than those of pregnant women with normal thyroid function(P<0.05).Conclusion Thyroid dysfunction in pregnant women has adverse effects on pregnancy outcomes and neonatal outcomes.The clinic

关 键 词：甲功五项 TPOAB TRAB 妊娠期妇女 

分 类 号：R392.6[医药卫生—免疫学]