甲状腺过氧化物酶抗体和球蛋白抗体与妊娠不良结局的关系

发布时间：2018-09-04 08:54

【摘要】：目的探讨妊娠早期妇女甲状腺过氧化物酶抗体(TPOAb)和(或)甲状腺球蛋白抗体(TGAb)阳性与自然流产、早产、妊娠期高血压疾病、有医学指征的剖宫产、胎盘早剥、胎儿死亡等妊娠不良结局的关系。方法选取首次妊娠妇女624例,在孕早期检测TSH、FT3、FT4、TPOAb、TGAb,并持续跟踪随访观察其妊娠结局,记录有无自然流产、早产、妊娠期高血压疾病、有医学指征的剖宫产、胎盘早剥、胎儿死亡等妊娠不良结局。结果 (1)624例患者发生妊娠不良结局共有104例(16.7%),居前两位是自然流产(33例)及妊娠期高血压疾病(27例)。(2)亚临床甲减组与甲功正常组比较,其总妊娠不良结局发生率、自然流产率均升高(P0.05)。(3)TPOAb和(或)TGAb抗体阳性组与抗体阴性组比较,其总不良结局发生率、自然流产率、妊娠期高血压疾病发生率升高(P0.05);甲功正常情况下,抗体阳性组与抗体阴性组比较,其总不良结局发生率也升高(P0.05);亚临床甲减情况下,抗体阳性组与抗体阴性组比较,其总不良结局发生率增高(P0.05)。结论无论是在甲功正常情况下还是亚临床甲减情况下,甲状腺自身抗体阳性与阴性的情况相比妊娠不良结局增高。
[Abstract]:Objective to investigate the relationship between thyroid peroxidase antibody (TPOAb) and / or thyroid globulin antibody (TGAb) positive in early pregnant women and spontaneous abortion, premature delivery, hypertensive disorder complicating pregnancy, cesarean section with medical indication, and placental abruption. The relationship between adverse outcome of pregnancy, such as fetal death. Methods TSH,FT3,FT4,TPOAb,TGAb, was detected in the first trimester of pregnancy in 624 women, and the pregnancy outcome was continuously followed up. The pregnancy outcome was recorded whether there were spontaneous abortion, premature delivery, hypertensive disorder complicating pregnancy, cesarean section with medical indication and placental abruption. Adverse outcome of pregnancy, such as fetal death. Results (1) there were 104 cases (16.7%) with adverse outcome of pregnancy in 624 cases, the first two were spontaneous abortion (33 cases) and hypertensive disorder complicating pregnancy (27 cases of). (2). The incidence of adverse outcome of pregnancy was higher in subclinical hypothyroidism group than in normal group. The rate of spontaneous abortion increased (P0.05). (3) TPOAb and / or TGAb antibody positive group compared with antibody negative group, its total adverse outcome rate, spontaneous abortion rate, gestational hypertension incidence increased (P0.05); A normal condition, the incidence of hypertension complicating pregnancy (P0.05); The incidence of total adverse outcome in antibody positive group and antibody negative group was higher than that in antibody negative group (P0.05); in subclinical hypothyroidism, the incidence of total adverse outcome in antibody positive group and antibody negative group was higher than that in antibody negative group (P0.05). Conclusion No matter in normal thyroid function or subclinical hypothyroidism, the adverse outcome of pregnancy is higher in the positive and negative cases of thyroid autoantibodies than in the cases of normal thyroid function and subclinical hypothyroidism.
【作者单位】：四川省绵阳市人民医院内分泌科;泸州医学院附属医院内分泌科;
【分类号】：R714.2

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