不同孕妇妊娠各期血清甲状腺激素及TPO-Ab水平变化及其相关性研究  

Study on the Changes and Correlation of Serum Thyroid Hormone and TPO-Ab Levels in Different Pregnant Women During Pregnancy Periods

作　　者：牛旭东 牛晓霞 NIU Xudong;NIU Xiaoxia(Department of Internal Medicine,Yinchuan Maternal and Child Health Hospital,Yinchuan 750001,Ningxia,China)

机构地区：[1]银川市妇幼保健院内科,宁夏银川750001

出　　处：《医学信息》2025年第7期82-86,共5页Journal of Medical Information

基　　金：宁夏自然科学基金项目(编号:NZ17245);宁夏回族自治区科技惠民专项项目(编号:2023CMG03030);自治区卫生健康系统科研课题(编号:74)。

摘　　要：目的探讨不同孕妇不同妊娠周期血清甲状腺激素水平的差异及其和甲状腺过氧化物酶抗体(TPO-Ab)的相关性。方法回顾性选取我院2022年5月-2023年5月收治的110例正常孕妇为正常孕产组,78例妊娠合并亚临床甲状腺功能减退(SCH)为亚甲减孕产组,100例无妊娠健康女性为无妊娠对照组,检测两组孕产组和无妊娠对照组血清甲状腺激素[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)]、TPO-Ab水平,分析血清甲状腺激素与TPO-Ab阳性的相关性。结果与无妊娠对照组比较,正常孕产组TSH较低,亚甲减孕产组TSH较高,两组妊娠组FT4、FT3均低于无妊娠对照组,亚甲减孕产组TPO-Ab高于无妊娠对照组(P均<0.05);亚甲减孕产组TSH、TPO-Ab均高于正常孕产组(P<0.05),FT4、FT3略低于正常孕产组,但差异无统计意义(P>0.05);正常孕产组不同孕期比较:TSH:孕早期<孕中期<孕晚期(P<0.05),呈上升趋势;正常孕产组不同孕期FT4、FT3:孕早期>孕中期>孕晚期,呈下降趋势(P<0.05);不同孕期TPO-Ab比较,差异无统计学意义(P>0.05);亚甲减孕产组不同孕期比较:TSH:孕早期<孕中期<孕晚期(P<0.05),呈上升趋势;孕产组不同孕期FT4、FT3呈下降趋势,FT3孕早期>孕中期>孕晚期(P<0.05),不同孕期FT4比较,差异无统计学意义(P>0.05);不同孕期TPO-Ab比较,差异有统计学意义(P<0.05)。亚甲减孕产组78例,TPO-Ab阳性率73.08%,血清TSH水平与TPO-Ab阳性率呈正相关(r=0.409,P<0.05),血清FT3与TPO-Ab阳性率呈负相关(r=-0.256,P<0.05),FT4水平与TPO-Ab阳性率无相关(r=-0.077,P>0.05)。结论妊娠孕产妇不同孕期血清甲状腺激素水平变化具有规律性,妊娠合并SCH孕产妇血清FT3、TSH水平与TPO-Ab阳性率密切相关。Objective To investigate the difference of serum thyroid hormone levels in different pregnant women during different pregnancy periods and its correlation with thyroid peroxidase antibody(TPO-Ab).Methods Retrospectively selected 110 normal pregnant women admitted to our hospital from May 2022 to May 2023 as normal pregnancy group,78 pregnant women with subclinical hypothyroidism(SCH)as subclinical hypothyroidism pregnancy group,and 100 non-pregnant healthy women as non-pregnant control group.The levels of serum thyroid hormones[thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroid hormone(FT4)]and TPO-Ab in the two groups of pregnant women and non-pregnant control group were detected,and the correlation between serum thyroid hormones and TPO-Ab positive was analyzed.Results Compared with the non-pregnancy control group,TSH in the normal pregnancy group was lower,and TSH in the subclinical hypothyroidism group was higher.FT4 and FT3 in the two pregnancy groups were lower than those in the non-pregnancy control group,and TPO-Ab in the subclinical hypothyroidism group was higher than that in the non-pregnancy control group(all P<0.05).TSH and TPO-Ab in the subclinical hypothyroidism group were higher than those in the normal pregnancy group(P<0.05),FT4 and FT3 were slightly lower than those in the normal pregnancy group,but the difference was not statistically significant(P>0.05).Comparison of different pregnancy periods in normal pregnancy group:TSH:early pregnancy<middle pregnancy<late pregnancy(P<0.05),showing an upward trend;FT4 and FT3 in normal pregnancy group at different pregnancy periods:early pregnancy>middle pregnancy>late pregnancy,showing a downward trend(P<0.05);Comparison of different pregnancy periods in the subclinical hypothyroidism group:TSH:early pregnancy<middle pregnancy<late pregnancy(P<0.05),showing an upward trend;In the normal pregnant group,FT4 and FT3 showed a downward trend during different pregnancy periods,FT3 in early pregnancy>middle pregnancy>late pregnancy(P<0.05

关 键 词：妊娠 亚临床甲状腺功能减退 甲状腺激素 TPO-AB 

分 类 号：R714.1[医药卫生—妇产科学]