孕早期甲状腺激素联合肝功能检测对妊娠不良结局的预测价值  

Predictive value of thyroid hormone combined with liver function tests in early pregnancy for adverse pregnancy outcomes

作　　者：杨峻 YANG Jun(Department of Clinical Laboratory,Wuhan Hongshan District Maternal and Child Health Care Hospital,Wuhan,Hubei 430070,China)

机构地区：[1]武汉市洪山区妇幼保健院检验科,湖北武汉430070

出　　处：《医药前沿》2025年第4期69-71,75,共4页Journal of Frontiers of Medicine

摘　　要：目的探讨孕早期甲状腺激素联合肝功能检测对妊娠不良结局的预测价值。方法回顾性分析2023年1—12月武汉市洪山区妇幼保健院收治的120例孕妇临床资料,依据妊娠结局分为良好组和不良组,两组均行孕早期甲状腺激素与肝功能检测,比较两组孕早期甲状腺激素[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)]及肝功能指标[总胆红素(TBIL)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)]水平,并绘制受试者工作特征(ROC)曲线,结合ROC曲线下面积(AUC),分析孕早期甲状腺激素联合肝功能检测对妊娠不良结局的预测价值。结果120例孕妇中,妊娠结局不良37例(30.83%,不良组),妊娠结局良好83例(69.17%,良好组)。不良组TSH、ALT、AST水平均高于良好组,FT3、FT4、TBIL水平均低于良好组,差异有统计学意义(P<0.05)。ROC曲线显示,孕早期TSH、FT3、FT4、TBIL、ALT、AST检测对妊娠不良结局预测价值的AUC均>0.6;孕早期甲状腺激素联合肝功能检测对妊娠不良结局预测价值的AUC为0.795,高于各项单独检测。结论妊娠不良结局受多方面因素影响,孕早期甲状腺激素联合肝功能检测对其具有较高预测价值。Objective To investigate the predictive value of thyroid hormone combined with liver function tests in early pregnancy for adverse pregnancy outcomes.Methods A retrospective analysis was conducted on the clinical data of 120 pregnant women admitted to Wuhan Hongshan District Maternal and Child Health Care Hospital from January 2023 to December 2023 and divided into the favorable group and the adverse group according to the pregnancy outcomes.Both groups underwent thyroid hormone and liver function tests in early pregnancy.The levels of thyroid hormones[thyroid-stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4)]and liver function indicators[total bilirubin(TBIL),alanine transaminase(ALT),aspartate transaminase(AST)]in early pregnancy were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn,and the area under curve(AUC)of the ROC was combined to analyze the predictive value of thyroid hormone combined with liver function tests in early pregnancy for adverse pregnancy outcomes.Results Among the 120 pregnant women,37 cases(30.83%,adverse group)had adverse pregnancy outcomes,and 83 cases(69.17%,favorable group)had favorable pregnancy outcomes.The levels of TSH,ALT,and AST in the adverse group were higher than those in the favorable group,while the levels of FT3,FT4,and TBIL were lower than those in the favorable group,with statistically significant differences(P<0.05).ROC curve showed that the AUC of TSH,FT3,FT4,TBIL,ALT and AST in early pregnancy for predicting adverse pregnancy outcomes were all>0.6.The AUC of thyroid hormone combined with liver function test in early pregnancy for predicting adverse pregnancy outcomes was 0.795,which was higher than that of each single test.Conclusions Adverse pregnancy outcomes are affected by many factors.Thyroid hormone combined with liver function test in early pregnancy has a high predictive value for it.

关 键 词：妊娠 不良结局 促甲状腺激素 游离三碘甲状腺原氨酸 游离甲状腺素 总胆红素 丙氨酸转氨酶 受试者工作特征曲线 

分 类 号：R581[医药卫生—内分泌]