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目的:探讨抗甲状腺抗体(ATA)与复发性自然流产(RSA)之间的关系。方法:收集2011年2~12月该院遗传门诊就诊有RSA病史的非孕期患者100例为病例组,同吋收集有正常分娩史非孕期妇女100例为对照组。采用化学发光法检测两组血清中的甲状腺球蛋白抗体(TGAb)和甲状腺过氧化物酶抗体(TPOAb)的含量。结果:①病例组中ATA总阳性率(TGAb或TPOAb任何一项或两项阳性者)、TGAb阳性率、TPOAb阳性率分别为22.00%、16.00%、18.00%,显著高于对照组的10.00%、5.00%、6.00%(P<0.05);经多因素分析,TPOAb阳性仍有统计学意义(OR=3.439,P=0.013)。②病例组TGAb和TPOAb定量值经对数转化后均数均高于对照组;经检验,两组log(TPOAb)的均数差异具有统计学意义(P=0.006)。③病例组中62例不明原因RSA的ATA总阳性率、TGAb阳性率、TPOAb阳性率分别为29.03%、19.35%、24.19%,均显著高于对照组(P<0.01),多因素分析可见,不明原因RSA组的TPOAb阳性暴露比是对照组的5倍(OR=5.000,P=0.002)。结论:①RSA患者的ATA总阳性率、TGAb及TPOAb阳性率均显著升高,TPOAb的定量值也升高。②TPOAb与RSA的关系更为密切。③ATA因素是RSA的独立危险因素。
Objective: To investigate the relationship between anti-thyroid antibody (ATA) and recurrent spontaneous abortion (RSA). Methods: From February to December in 2011, 100 cases of non-pregnant patients with RSA history in the outpatient department of the hospital were selected as the case group. 100 cases of non-pregnant women with normal delivery history were collected as the control group. The levels of thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) in serum of two groups were detected by chemiluminescence method. Results: ① The positive rate of ATA in all cases (positive for TGAb or TPOAb), positive rate of TGAb and positive rate of TPOAb in case group were 22.00%, 16.00% and 18.00%, respectively, which were significantly higher than those in control group (10.00% , 5.00% and 6.00%, respectively (P <0.05). After multivariate analysis, the TPOAb positive was still statistically significant (OR = 3.439, P = 0.013). ② The TGAb and TPOAb quantitative values in the case group after logarithmic transformation were higher than those in the control group. After the test, the mean difference of log (TPOAb) between the two groups was statistically significant (P = 0.006). ③ The total positive rate of ATA, the positive rate of TGAb and the positive rate of TPOAb in 62 cases of unexplained RSA in case group were 29.03%, 19.35% and 24.19%, respectively, which were significantly higher than those in control group (P <0.01) .Multivariate analysis showed that, The unexplained RSA group had a 5-fold higher TPOAb-positive exposure than the control group (OR = 5.000, P = 0.002). Conclusion: ① The positive rate of ATA, the positive rate of TGAb and TPOAb in RSA patients were significantly increased, and the quantitative value of TPOAb was also increased. ② TPOAb and RSA more closely. ③ ATA factor is an independent risk factor for RSA.