甲状腺过氧化物酶抗体对妊娠期甲状腺功能减退的监测意义
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摘要
目的观察甲状腺过氧化物酶抗体(TPOAb)对妊娠期甲状腺功能减退的监测意义。方法选择我院2015年1月—2018年1月初次产检的孕早期甲状腺功能减退孕妇679例,其中TPOAb阳性101例作为A组,阴性578例作为B组。选择同期甲状腺功能正常的孕妇3050例,其中TPOAb阳性362例作为C组,阴性2688例作为D组。观察4组妊娠不良结局发生情况。结果 A组自然流产、死胎、早产及足月小样儿发生率均高于B组(P <0. 05)。C组自然流产、死胎、早产及足月小样儿发生率均高于D组(P <0. 05)。结论促甲状腺激素和TPOAb联合检测可及时了解妊娠期母儿甲状腺功能,并通过合理干预可能有效避免妊娠不良结局发生。
Objective To observe significance of thyroid peroxidase antibody( TPOAb) in monitoring hypothyroidism during gestational period. Methods A total of 679 pregnant women with hypothyroidism in early pregnancy in the first time of antenatal care during January 2015 and January 2018 were selected. Among them,101 pregnant women with positive TPOAb were used as group A,and 578 pregnant women with negative TPOAb were used as group B. Other3050 pregnant women with normal thyroid function at the same period were selected,of which there were 362 pregnant women with positive TPOAb in group C and 2688 pregnant women with negative TPOAb in group D. Incidence rates of adverse outcome were observed in four groups. Results Incidence rates of spontaneous abortion,stillbirth,premature birth and small-for-date infant in group A were higher than those in group B( P < 0. 05). Incidence rates of spontaneous abortion,stillbirth,premature birth and small-for-date infant in group C were higher than those in group D( P < 0. 05).Conclusion Thyroid stimulating hormone( TSH) and TPOAb combined examination may timely know maternal and fetal thyroid function during gestational period,and possibility of adverse pregnancy outcomes can be avoided through reasonable intervention.
Objective To observe significance of thyroid peroxidase antibody( TPOAb) in monitoring hypothyroidism during gestational period. Methods A total of 679 pregnant women with hypothyroidism in early pregnancy in the first time of antenatal care during January 2015 and January 2018 were selected. Among them,101 pregnant women with positive TPOAb were used as group A,and 578 pregnant women with negative TPOAb were used as group B. Other3050 pregnant women with normal thyroid function at the same period were selected,of which there were 362 pregnant women with positive TPOAb in group C and 2688 pregnant women with negative TPOAb in group D. Incidence rates of adverse outcome were observed in four groups. Results Incidence rates of spontaneous abortion,stillbirth,premature birth and small-for-date infant in group A were higher than those in group B( P < 0. 05). Incidence rates of spontaneous abortion,stillbirth,premature birth and small-for-date infant in group C were higher than those in group D( P < 0. 05).Conclusion Thyroid stimulating hormone( TSH) and TPOAb combined examination may timely know maternal and fetal thyroid function during gestational period,and possibility of adverse pregnancy outcomes can be avoided through reasonable intervention.
引文
[1]李建华.甲状腺功能检测在重工业区妇女妊娠期的应用[J].中华全科医学,2013,11(11):1779-1780.
[2]Thangaratinam S,Tan A,Knox E,et al. Association between thyroid autoantibodies and miscarriage and preterm birth:meta-analysis of evidence[J]. BMJ,2011,342:d2616.
[3]Stagnaro-green A,Abalovich M,Alex-ander E,et al.Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancyand postpartum[J]. Thyoid,2011,21(10):1081-1125.
[4]黄彦红,杨柳,张莉,等.妊娠妇女甲状腺功能变化及其与妊娠并发症、妊娠结局及新生儿甲状腺功能的相关性研究[J].中国妇幼保健,2014,29(7):1025-1028.
[5]王亦丹,徐友娣.妊娠期亚临床甲减者TPOAb与妊娠结局相关性分析[J].中国妇幼健康研究,2016,27(3):308-311.
[6]荣蓉,王宏星,高红菊. TPOAb对妊娠期亚临床甲状腺功能减退女性妊娠结局的影响[J].中国妇幼健康研究,2017,28(4):400-402.
[7]张大川,王良池,赵继军,等.微创颅内血肿抽吸术对高血压脑出血患者神经功能的影响[J].重庆医学,2013,42(1):59-60.
[8]黄志云.微创颅内血肿抽吸术治疗老年外伤性颅内血肿的护理[J].河南外科学杂志,2014,20(1):141-142.
[9]李品霞.血清TPOAb、TSH、TGA检测在孕妇甲状腺疾病筛查中的意义[J].国际检验医学杂志,2016,37(17):2426-2428.
[10]孙伟杰,杨慧霞.妊娠期甲状腺疾病的筛查模式探讨[J].中华围产医学杂志,2015,18(12):881-884.
[11]郭琼,赵梅.妊娠期甲状腺疾病临床筛查指标及亚临床甲状腺功能减退症对妊娠结局的影响分析[J].中国妇幼保健,2016,31(24):5321-5323.
[12]黄毅文,董作亮,胡志东.孕妇相关甲状腺疾病研究进展[J].国际检验医学杂志,2014,35(18):2502-2504.
[13]罗亚红,刘萍,郭海荣,等.妊娠期合并甲状腺功能减退症研究进展[J].中国妇幼健康研究,2015,26(5):1094-1097.
[14]崔风云.妊娠过程中甲状腺功能的变化和筛查[J].河北医学,2017,23(3):433-436.
[15]王洁,陈晓娟.妊娠期甲状腺疾病筛查和干预对妊娠结局的影响[J].中国医药导报,2015,12(23):71-74.
[16]Furukawa S,Miyakawa K,Shibata J,et al. Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan[J]. Tohoku J Exp Med,2017,242(3):167.
[17]魏延斌,李红芹,赵楠,等.妊娠合并甲状腺功能减退142例临床分析[J].中国妇幼保健,2015,30(25):4277-4278.
[18]刘文静,吕焱.左旋甲状腺素片治疗对妊娠合并亚临床甲状腺功能减退孕妇妊娠结局的影响[J].中国妇幼保健,2016,31(17):3506-3508.
[19]刘云,陈媛媛,张西艺,等.左旋甲状腺素片治疗妊娠合并甲状腺功能减退的安全性及对妊娠结局影响[J].疑难病杂志,2016,15(4):405-408.
[20]舒展,高芳,房秋霞,等.妊娠期妇女甲状腺功能减退对妊娠结局和胎儿不良结局的影响[J].贵州医药,2017,41(2):181-183.
[21]孙亚玲,辛春,郭明,等.早期综合干预结合左甲状腺素钠治疗妊娠合并甲状腺功能减退对母婴结局及预后的影响[J].临床合理用药杂志,2016,9(1):100-101.
[2]Thangaratinam S,Tan A,Knox E,et al. Association between thyroid autoantibodies and miscarriage and preterm birth:meta-analysis of evidence[J]. BMJ,2011,342:d2616.
[3]Stagnaro-green A,Abalovich M,Alex-ander E,et al.Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancyand postpartum[J]. Thyoid,2011,21(10):1081-1125.
[4]黄彦红,杨柳,张莉,等.妊娠妇女甲状腺功能变化及其与妊娠并发症、妊娠结局及新生儿甲状腺功能的相关性研究[J].中国妇幼保健,2014,29(7):1025-1028.
[5]王亦丹,徐友娣.妊娠期亚临床甲减者TPOAb与妊娠结局相关性分析[J].中国妇幼健康研究,2016,27(3):308-311.
[6]荣蓉,王宏星,高红菊. TPOAb对妊娠期亚临床甲状腺功能减退女性妊娠结局的影响[J].中国妇幼健康研究,2017,28(4):400-402.
[7]张大川,王良池,赵继军,等.微创颅内血肿抽吸术对高血压脑出血患者神经功能的影响[J].重庆医学,2013,42(1):59-60.
[8]黄志云.微创颅内血肿抽吸术治疗老年外伤性颅内血肿的护理[J].河南外科学杂志,2014,20(1):141-142.
[9]李品霞.血清TPOAb、TSH、TGA检测在孕妇甲状腺疾病筛查中的意义[J].国际检验医学杂志,2016,37(17):2426-2428.
[10]孙伟杰,杨慧霞.妊娠期甲状腺疾病的筛查模式探讨[J].中华围产医学杂志,2015,18(12):881-884.
[11]郭琼,赵梅.妊娠期甲状腺疾病临床筛查指标及亚临床甲状腺功能减退症对妊娠结局的影响分析[J].中国妇幼保健,2016,31(24):5321-5323.
[12]黄毅文,董作亮,胡志东.孕妇相关甲状腺疾病研究进展[J].国际检验医学杂志,2014,35(18):2502-2504.
[13]罗亚红,刘萍,郭海荣,等.妊娠期合并甲状腺功能减退症研究进展[J].中国妇幼健康研究,2015,26(5):1094-1097.
[14]崔风云.妊娠过程中甲状腺功能的变化和筛查[J].河北医学,2017,23(3):433-436.
[15]王洁,陈晓娟.妊娠期甲状腺疾病筛查和干预对妊娠结局的影响[J].中国医药导报,2015,12(23):71-74.
[16]Furukawa S,Miyakawa K,Shibata J,et al. Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan[J]. Tohoku J Exp Med,2017,242(3):167.
[17]魏延斌,李红芹,赵楠,等.妊娠合并甲状腺功能减退142例临床分析[J].中国妇幼保健,2015,30(25):4277-4278.
[18]刘文静,吕焱.左旋甲状腺素片治疗对妊娠合并亚临床甲状腺功能减退孕妇妊娠结局的影响[J].中国妇幼保健,2016,31(17):3506-3508.
[19]刘云,陈媛媛,张西艺,等.左旋甲状腺素片治疗妊娠合并甲状腺功能减退的安全性及对妊娠结局影响[J].疑难病杂志,2016,15(4):405-408.
[20]舒展,高芳,房秋霞,等.妊娠期妇女甲状腺功能减退对妊娠结局和胎儿不良结局的影响[J].贵州医药,2017,41(2):181-183.
[21]孙亚玲,辛春,郭明,等.早期综合干预结合左甲状腺素钠治疗妊娠合并甲状腺功能减退对母婴结局及预后的影响[J].临床合理用药杂志,2016,9(1):100-101.