产妇不同甲状腺过氧化物酶抗体水平对新生儿甲状腺功能的影响研究

发布时间：2018-06-10 10:38

  本文选题：妊娠 + 甲状腺过氧化物酶抗体　； 参考：《中国全科医学》2017年36期

【摘要】：目的探讨产妇不同甲状腺过氧化物酶抗体(TPOAb)水平对新生儿甲状腺功能的影响。方法 2015年1月—2016年6月,选取保定市第一中心医院收治的符合纳入标准的单纯TPOAb阳性产妇33例作为TPOAb阳性组,另选取同期于本院分娩的30例健康产妇作为TPOAb阴性组。所有产妇随访至产后6个月。将新生儿根据其母亲孕晚期TPOAb水平分为N组(母亲为TPOAb阴性组)、A组(母亲为TPOAb阳性组),再将A组新生儿依据其母亲孕晚期TPOAb水平分为A1亚组(母亲孕晚期TPOAb为30~100 U/ml,n=21)和A2亚组(母亲孕晚期TPOAb100 U/ml,n=12)。比较N组、A组新生儿出生情况评估资料,N组、A1亚组、A2亚组新生儿出生3~5 d和A1、A2亚组新生儿出生1、3个月甲状腺功能指标[促甲状腺激素(TSH)、游离甲状腺素(FT_4)水平]、甲状腺抗体指标[TPOAb、甲状腺球蛋白抗体(TGAb)、甲状腺球蛋白(TG)水平],并分析TPOAb阳性产妇后代出生3~5 d TSH、FT_4水平与产妇年龄、TPOAb水平的相关性。结果 N组和A组新生儿出生1 min Apgar评分、身长、体质量比较,差异无统计学意义(P0.05)。A1、A2亚组新生儿出生3~5 d TSH、TPOAb、TGAb、TG水平均高于N组,FT_4水平低于N组(P0.05);A2亚组新生儿出生3~5 d TSH、TPOAb、TGAb、TG水平均高于A1亚组,FT_4水平低于A1亚组(P0.05)。A1亚组新生儿出生1个月失访4例。A1、A2亚组新生儿出生1个月FT_4水平比较,差异无统计学意义(P0.05);A2亚组新生儿出生1个月TSH、TPOAb、TGAb、TG水平高于A1亚组(P0.05)。A1亚组新生儿出生3个月失访2例。A1、A2亚组新生儿出生3个月FT_4、TPOAb、TG水平比较,差异无统计学意义(P0.05)。A2亚组新生儿出生1个月TSH、TGAb水平高于A1亚组(P0.05)。Pearson相关分析结果显示,出生3~5 d时新生儿TSH、FT_4与其母亲TPOAb水平呈正相关(r值分别为0.393、0.423,P值均0.05)。结论产妇单纯TPOAb阳性对新生儿甲状腺功能有影响,且产妇TPOAb高水平对新生儿甲状腺功能的影响时间更长。
[Abstract]:Objective to investigate the effect of different levels of thyroid peroxidase antibody (TPOAb) on the thyroid function of newborns. Methods from January 2015 to June 2016, 33 pregnant women with TPOAb positive were selected as TPOAb positive group, and 30 healthy women in the same period were selected as TPOAb negative group. All women were followed up until 6 months postpartum. The newborns were divided into N group (mother TPOAb negative group) (mother was TPOAb positive group) and A group was divided into A1 subgroup according to their mother's late pregnancy TPOAb level. Subgroup A _ 2 (maternal TPOAb100 U / ml) and A _ 2 subgroup (TPOAb100 U / ml) and A _ 2 subgroup. Comparison of neonatal birth assessment data of group N and group A (A 1 subgroup A 2) thyroid function index [thyrotropin TSHT, free thyroxine FT 4], A 2 subgroup and 1 month and 3 months old neonates in group A and A 1 / A subgroup respectively were compared respectively, and 1 month after birth, 1 month after birth. The level of TPOAb (TPOAb, TGAb, TGG) was analyzed, and the correlation between TPOAb level and TPOAb level was analyzed on the 3rd and 5th day after birth. Results 1 min Apgar score, body length and body weight of newborns in group N and group A were compared. There was no significant difference in TG levels of TSHTPOAbAbA1A 2 subgroup and TSHTPOAbAb5 TGAb4 group. All the levels of TG were higher than those of group N and group N were lower than those of group N and group P 0.05 A 2 respectively. TG levels of TSHTPOAbAbA subgroup were higher than those of subgroup A1 subgroup (P 0.05), respectively. The level of TG was higher than that of subgroup A1 (P 0.05) .A1 subgroup was lower than that of A1 subgroup (P 0.05). A1 subgroup was lower than that of A1 subgroup (P 0.05). A1 subgroup was lower than A1 subgroup (P 0.05). Comparison of FTS4 levels in 4 newborns in the A1AA2 subgroup at 1 month after birth. There was no significant difference in TG level of TSHO TPOAbn TGAbAb1 group 1 month old compared with that of A1 subgroup P0.05O.A1 subgroup. 2 newborns with 3 month loss of birth in A1 A1A2 subgroup were compared with 2 cases with 3 months FTS T POAbAb TG level in A1A1A2 subgroup were compared with that in A1 subgroup, and there was no statistical difference in TG level between the two newborns at the first month after birth. There was no significant difference in the level of TSHTGAb in newborns at one month after birth in group P0.05. A2. The results of Pearson correlation analysis showed that there was a positive correlation between TSH-FT4 and TPOAb in newborns at 3d after birth. The values of TSHTGAb were both 0.3930.423P and 0.05P, respectively. Conclusion simple TPOAb positive in puerpera has influence on neonatal thyroid function, and the high level of TPOAb in parturient has longer influence on neonatal thyroid function.
【作者单位】： 河北省保定市第一中心医院内分泌二科;
【分类号】：R722.1

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