妊娠早期单纯甲状腺自身抗体阳性孕妇妊娠结局分析

发布时间：2018-03-02 20:13

本文选题：甲状腺过氧化物酶抗体　切入点：甲状腺球蛋白抗体　出处：《中国妇产科临床杂志》2015年02期 　论文类型：期刊论文

【摘要】：目的观察妊娠早期单纯甲状腺自身抗体阳性孕妇妊娠晚期甲状腺功能(甲功)变化及妊娠结局,了解甲状腺自身抗体对妊娠的影响。方法选择妊娠早期127例甲功正常、甲状腺过氧化物酶抗体(TPOAb)或(和)甲状腺球蛋白抗体(TG-Ab)阳性孕妇为研究组,223例甲功正常、TPO-Ab和TG-Ab阴性妊娠早期孕妇为对照组,随访妊娠结局。结果研究组28.35%(36/127)的孕妇妊娠晚期出现甲功紊乱,其中11.81%(15/127)为亚临床甲状腺功能减退(甲减),7.87%(10/127)为临床甲减;对照组10.31%(23/223)的孕妇出现甲功紊乱,其中2.69%(6/223)为亚临床甲减,2.24%(5/223)为临床甲减,两组比较,差异有统计学意义(P0.05)。研究组流产率(18.90%,24/127)、早产率(22.83%,29/127)及胎儿窘迫率(7.87%,10/127)与对照组流产率(9.42%,21/223;8.52%,19/223;2.69%,6/223)比较,差异均有统计学意义(P0.05);两组单纯低T4血症、死胎、胎儿畸形及低出生体质量儿发生率比较,差异均无统计学意义(P0.05);研究组产后甲状腺炎发生率(40.16%,51/127)显著高于对照组(10.17%,18/177)(P0.05)。结论妊娠早期单纯甲状腺自身抗体阳性孕妇妊娠晚期发生甲功紊乱及不良妊娠结局风险明显增高,加强妊娠早期甲功筛查有意义。
[Abstract]:Objective to observe the changes of thyroid function (thyroid function) and pregnancy outcome in pregnant women with simple thyroid autoantibody positive in early pregnancy, and to understand the effect of thyroid autoantibody on pregnancy. Methods 127 cases of thyroid autoantibody in early pregnancy were selected as normal thyroid function. The pregnant women with positive thyroid peroxidase antibody (TPO-Ab) or / and thyroglobulin antibody (TG-Ab) were used as the control group. Results the third trimester of pregnant women in the study group (28.35 / 127) developed thyroid dysfunction, of which 11.81% 15 / 127) was clinical hypothyroidism (7.87% / 127), while in the control group 10.31% (23 / 223) had thyroid dysfunction. Of these, 2.69% 22% were subclinical hypothyroidism and 2.24% / 22 3) clinical hypothyroidism. The difference between the two groups was statistically significant (P 0.05). The abortion rate in the study group was 18.90% 127m, the premature delivery rate was 22.83% 29 / 127) and the fetal distress rate was 7.87% 10 / 127), compared with the control group's abortion rate of 9.42m21 / 2238.52T 192238.52n 192238.522 / 192232.69p / 223. The difference was statistically significant (P 0.05), the incidence of simple hypothyroidism, stillbirth, fetal malformation and low birth weight infants were compared between the two groups. The incidence of postpartum thyroiditis in the study group was significantly higher than that in the control group (P < 0.01 / 127). Conclusion the thyroid dysfunction and the risk of adverse pregnancy outcome were significantly increased in pregnant women with simple thyroid autoantibody positive in the early pregnancy, and the incidence of postpartum thyroiditis in the study group was significantly higher than that in the control group. It is meaningful to strengthen the screening of thyroid function in early pregnancy.
【作者单位】：湖北省荣军医院妇产科;
【分类号】：R714.256

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