不同TSH标准诊断的妊娠早期亚甲减及TPO-Ab阳性对妊娠的影响分析

发布时间：2018-01-02 22:02

本文关键词：不同TSH标准诊断的妊娠早期亚甲减及TPO-Ab阳性对妊娠的影响分析　出处：《现代医学》2016年12期 　论文类型：期刊论文

【摘要】：目的:探讨不同促甲状腺激素(TSH)标准诊断的妊娠早期亚临床型甲状腺功能减退(亚甲减)及甲状腺过氧化物酶抗体(TPO-Ab)阳性对妊娠的影响。方法:选取我院产科孕早期开始行产前检查至结束妊娠的孕妇1 025例,在不同的TSH诊断标准(A标准TSH2.5 mU·L~(-1)、B标准TSH5.76 mU·L~(-1))下不同TPO-Ab检测结果患者的亚甲减发生率、妊娠并发症和妊娠不良结局发生率以及胎儿不良结局发生率的差异。结果:研究对象TPO-Ab阳性率为12.29%;按A标准,TPO-Ab阳性者亚甲减发生率高于TPO-Ab阴性者(P0.05);按B标准,TPO-Ab阳性者亚甲减发生率也高于TPO-Ab阴性者(P0.05)。妊娠并发症和妊娠不良结局发生率按A标准者低于按B标准者(P0.05),且按B标准TPO-Ab阳性者高于TPO-Ab阴性者(P0.05)。胎儿不良结局发生率按A标准者低于按B标准者(P0.05),且按A标准TPO-Ab阳性者高于TPO-Ab阴性者,按B标准TPO-Ab阳性者也高于TPO-Ab阴性者,差异均有统计学意义(P0.05)。结论:TSH和TPO-Ab是预测甲状腺功能异常和妊娠不良结局的重要临床指标,目前国际惯用TSH2.5 mU·L~(-1)为亚甲减的诊断标准,其更利于预测甲状腺功能异常和妊娠不良结局的发生。
[Abstract]:Objective: to investigate subclinical hypothyroidism (hypothyroidism) and thyroid peroxidase antibody (TPO-Abb) in early pregnancy diagnosed by different TSH criteria. Methods: 1 025 pregnant women in our hospital from the beginning of antenatal examination to the end of pregnancy were selected. In different TSH diagnostic criteria, A standard TSH2.5 mu 路LU -1). The incidence of hypothyroidism in patients with different TPO-Ab results under B standard TSH5.76 mu 路L ~ (-1). Results: the positive rate of TPO-Ab was 12.29%. The incidence of hypothyroidism in TPO-Ab positive group was higher than that in TPO-Ab negative group (P 0.05). B standard. The incidence of hypothyroidism in TPO-Ab positive patients was also higher than that in TPO-Ab negative patients (P 0.05). The incidence of fetal adverse outcome in patients with TPO-Ab positive according to B standard was higher than that in those with negative TPO-Ab, and the incidence of fetal adverse outcome was lower than that in patients with B standard (P 0.05). TPO-Ab positive according to A standard was higher than TPO-Ab negative, and TPO-Ab positive according to B standard was higher than TPO-Ab negative. Conclusion TSH and TPO-Ab are important clinical indexes for predicting abnormal thyroid function and adverse outcome of pregnancy. At present, TSH2.5 mu 路L ~ (-1) is used as the diagnostic standard of hypothyroidism, which is more helpful to predict the abnormal thyroid function and the adverse outcome of pregnancy.
【作者单位】：南京医科大学附属淮安第一医院产科;
【分类号】：R714.256
【正文快照】： 妊娠期孕妇甲状腺体积增大,血流较之前丰富,甲状腺激素水平上升,同时体内人绒毛膜促性腺激素、促甲状腺激素(thyroidstimulating hormone,TSH)等出现规律化变动[1]。甲状腺功能障碍易引发贫血、高血压等并发症,造成不良妊娠结局,是妊娠期常见内分泌疾病[2]。妊娠期TSH水平、甲

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