妊娠期甲状腺功能异常患者血清TPOAb、Tg、Tg-Ab变化及与妊娠结局的关系  

Changes of serum TPOAb,Tg and Tg-Ab in patients with gestational thyroid dysfunction and their relationship with pregnancy outcomes

作　　者：刘治红 欧海涛 王云川 LIU Zhihong;OU Haitao;WANG Yunchuan(Department of Laboratory Medicine,Nanchong Mental and Physical Hospital,Nanchong,Sichuan 637770,China)

机构地区：[1]四川省南充市身心医院检验科,四川南充637770

出　　处：《公共卫生与预防医学》2024年第6期161-164,共4页Journal of Public Health and Preventive Medicine

基　　金：四川省南充市科技计划项目(21YFZJZC0006)。

摘　　要：目的探讨妊娠期甲状腺功能异常患者血清甲状腺过氧化物酶抗体(thyroid peroxidase antibodies,TPOAb)、甲状腺球蛋白(thyroglobulin,Tg)、抗甲状腺球蛋白抗体(anti-thyroglobulin antibodies,Tg-Ab)变化及与妊娠结局的关系。方法选取2020年1月至2022年12月在南充市身心医院就诊的98例妊娠期甲状腺功能异常患者的临床资料进行研究。按照疾病类型将上述患者分为甲亢组(n=50)与甲减组(n=48)。另选同期进行健康体检的甲状腺功能正常孕妇100例,作为健康组(n=100)。比较三组研究对象的血清促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺激素(FT4)、TPOAb、Tg、Tg-Ab水平以及母婴妊娠结局。将妊娠期甲状腺功能异常患者按照母婴妊娠结局分为正常妊娠组(n=68)与不良妊娠组(n=30),比较两组患者的血清TPOAb、Tg、Tg-Ab水平。结果与健康组相比,甲亢组孕妇血清TSH水平下降(P<0.05),血清FT3、FT4、Tg、Tg-Ab、TPOAb水平上升(P<0.05);与健康组相比,甲减组孕妇血清FT3、FT4水平下降(P<0.05),血清TSH、TPOAb、Tg、Tg-Ab水平上升(P<0.05);甲亢组孕妇血清TSH水平低于甲减组(P<0.05),血清FT3、FT4、Tg、Tg-Ab、TPOAb水平高于甲减组(P<0.05)。甲亢组总不良妊娠结局率34.00%与甲减组总不良妊娠结局率27.08%比较差异无统计学意义(P>0.05),且两组均高于健康组总不良妊娠结局率9.00%(P<0.05)。不良妊娠组孕妇血清TSH、TPOAb、Tg-Ab水平均高于正常妊娠组(P<0.05)。结论妊娠期甲状腺功能异常患者血清TPOAb、Tg、Tg-Ab水平出现异常升高,且与不良妊娠结局相关,临床应加强重视,提早干预。Objective To explore the changes of serum thyroid peroxidase antibody(TPOAb),thyroglobulin(Tg),and anti-thyroglobulin antibody(Tg-Ab)in patients with gestational thyroid dysfunction and their relationship with pregnancy outcomes.Methods The clinical data were collected from 98 patients with gestational thyroid dysfunction in Nanchong Mental and Physical Hospital between January 2020 and December 2022.According to disease types,patients were divided into hyperthyroidism group(n=50)and hypothyroidism group(n=48).A total of 100 pregnant women with normal thyroid function during the same period were enrolled as the healthy group.The levels of serum thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroid hormone(FT4),TPOAb,Tg and Tg-Ab,and maternal and neonatal outcomes were compared among the three groups.According to maternal and neonatal outcomes,patients with gestational thyroid dysfunction were divided into normal pregnancy group(n=68)and adverse pregnancy group(n=30),and levels of serum TPOAb,Tg and Tg-Ab were compared between the two groups.Results Compared with the healthy group,level of serum TSH was decreased in the hyperthyroidism group(P<0.05),while levels of serum FT3,FT4,Tg,Tg-Ab and TPOAb were increased(P<0.05).Compared with the healthy group,levels of serum FT3 and FT4 were decreased in the hypothyroidism group(P<0.05),while levels of serum TSH,TPOAb,Tg and Tg-Ab were increased(P<0.05).The level of serum TSH in the hyperthyroidism group was lower than that in the hypothyroidism group(P<0.05),while levels of serum FT3,FT4,Tg,Tg-Ab and TPOAb were higher than those in the hypothyroidism group(P<0.05).There was no significant difference in the overall incidence of adverse pregnancy outcomes between the hyperthyroidism group and the hypothyroidism group(34.00%vs 27.08%,P>0.05),but the overall adverse pregnancy outcome rate in the two groups was higher than that in the healthy group(9.00%,P<0.05).The levels of serum TSH,TPOAb and Tg-Ab in adverse pregnancy group were higher than those in nor

关 键 词：妊娠期甲状腺功能异常 甲状腺球蛋白抗体 甲状腺球蛋白 甲状腺过氧化物酶抗体 妊娠结局 

分 类 号：R181[医药卫生—流行病学]