妊娠早期甲状腺功能异常及自身抗体筛查的临床研究

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目的观察妊娠早期甲状腺过氧化物酶抗体(TPOAb)与甲状腺功能的相关性及对妊娠的影响。方法 TPOAb阳性的妊娠早期孕妇42例作为观察组,TPOAb阴性的妊娠早期患者40例作为对照组,记录两组患者妊娠病史及观察两组之间血清促甲状腺激素(TSH)、游离甲状腺素(FT4)水平情况。结果①两组患者一般资料及既往病史对比:两组患者在年龄、孕周、胎次差异上无统计学意义(P>0.05);既往不良病史(包括流产、死胎)观察组共12例(占28.6%),对照组共5例(占12.5%),两组间差异有统计学意义(P<0.05)。②两组患者TSH与TF4水平对比:观察组仅TSH升高及TF4降低并TSH升高人数比例明显高于对照组(P<0.05);而仅TF4降低人数比例与对照组差异无统计学意义(P>0.05)。③两组患者不良事件发生对比:观察组患者不良事件总发生人数比例为26.2%(11/42),对照组患者不良事件总发生人数比例为10%(4/40),两组差异有统计学意义(P<0.05)。④TSH、TF4与TPOAb水平相关性分析:TSH与TPOAb水平呈正相关(r=0.08,P<0.05);而TF4与TPOAb水平无明显相关性(r=-0.02,P>0.05)。结论 TSH与TPOAb水平呈正相关,TPOAb与甲状腺功能异常相关,妊娠早期及时检测TPOAb水平有助于减少对甲状腺功能异常孕妇遗漏。 Objective To observe the correlation between thyroid peroxidase antibody (TPOAb) and thyroid function in early pregnancy and its effect on pregnancy. Methods Forty-two pregnant women with TPOAb-positive early pregnancy were selected as observation group and 40 pregnant women with TPOAb-negative early pregnancy as control group. Pregnancy history and serum TSH and FT4 levels were compared between the two groups. The level of the situation. Results ① There was no significant difference between the two groups in general information and past medical history. There was no significant difference between the two groups in age, gestational age and parity (P> 0.05). In the past 12 cases (including miscarriage and stillbirth) Accounting for 28.6%). There were 5 cases in the control group (12.5%), with significant difference between the two groups (P <0.05). (2) The levels of TSH and TF4 in both groups were significantly higher than those in the control group (P <0.05). Only TSH increased and TF4 decreased and the TSH increased in the observation group were significantly higher than those in the control group (P> 0.05). The adverse events in both groups were compared: the proportion of the total number of adverse events in the observation group was 26.2% (11/42), and the proportion of the total number of adverse events in the control group was 10% (4/40) Significance (P <0.05). The correlation between TSH, TF4 and TPOAb levels: There was a positive correlation between TSH and TPOAb levels (r = 0.08, P <0.05), while there was no significant correlation between TF4 and TPOAb levels (r = -0.02, P> 0.05). Conclusions There is a positive correlation between TSH and TPOAb levels. TPOAb is associated with abnormal thyroid function. The detection of TPOAb in early pregnancy may help to reduce the omission of thyroid dysfunction in pregnant women.
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