摘要
目的 探讨甲状腺自身抗体阳性妇女孕期甲状腺功能干预对婴儿甲状腺功能的影响.方法选择产前检查发现的甲状腺过氧化物酶抗体（TPOAb）和（或）甲状腺球蛋白抗体（TgAb）阳性妊娠妇女55例.随机分为干预组（子代为A）36例和非干预组（子代为B）19例,设同期自身抗体阴性对照组（子代为N）30例.选择左旋甲状腺素片作为干预制剂.采用化学发光酶免疫分析法测定3组入选后和分娩前空腹血清TPOAb、TgAb、TSH、TT3、TT4、FT3、FT4水平,同时测定母体尿碘含量.新生儿出生后测定脐血、出生后3～4周及8～10周静脉血TSH、TT3、TT4、FT3、FT4水平.结果干预组、非干预组母体基线血清TSH水平显著高于对照组（P＜0.05）.分娩前非干预组与另两组比较,血清TSH增高和TT3、TT4、FT4降低具有统计学差异（P＜0.05或P＜0.01）.胎儿出生后脐血TSH水平在B组（7.06±1.31）mIU/L和A组（6.23±1.26）mIU/L均显著高于N组（5.48±1.17）mIU/L（P＜0.01或P＜0.05）.出生3～4周新生儿B组血清TSH（3.21±0.70）mIU/L高于N组[（2.72±0.51）mIU/L]和A组[（2.78±0.42）mIU/L,均P＜0.05].出生8～10周婴儿B组血清TSH[（2.99±0.57）mIU/L]高于N组[（2.48±0.68）mIU/L,P＜0.05].多元逐步回归分析,母体TSH、TPOAb及尿碘含量与婴儿TSH独立相关.结论不同甲状腺功能状态的妊娠妇女,其子代出生后的甲状腺功能存在差异.胎儿出生后甲状腺功能与母亲甲状腺自身抗体及孕期甲状腺功能状态有关.
Objective To study influences of intervention in pregnant women with positive thyroid autoantibodies on the thyroid function of babies. Methods A total of 55 pregnant women were enrolled with positive thyroid peroxidase antibody （TPOAb） and/or thyroglobulin antibody （TgAb） during prenatal checkup. They were randomly divided into two groups： intervening group（ n= 36, newborn group A） was treated with levothyroxine （ L-T4 ）, and non-intervening group （ n= 19, newborn group B） was not treated. 30 cases of pregnant women with negative thyroid autoantibodies served as a normal population control group （newborn group N）. Serum TSH, TPOAb, TgAb, TT3, TT4, FT3 and FT4 were measured by high-sensitive immunochemiluminescent assay ,and urinary iodine was also examined in the pregnant women. Fetal plasma TSH, TT3, TT4, FT3, and FT4 levels were measured after cutting the umbilical cord from placenta, and repeated measurements were made by 3-4 weeks and 8-10 weeks postpartum. Results At baseline, serum TSH levels of the pregnant women in intervening and nonintervening groups were significantly higher than that in control group （ P〈0.05 ）. Non-intervening group had higher TSH and lower TT3, TT4, FT4 compared with the other two groups （P〈0. 05 or P〈0.01 ）. The cord blood TSH levels of the neonates in both group B [（7.06 ± 1.31 ） mIU/L] and group A [（6.23 ± 1.26 ） mIU/L] were significantly higher than that of group N [（5.48±1. 17） mIU/L, P〈0.01 and 0. 05]. By 3-4 weeks postpartum,the serum TSH level [（3.21±0.70）mIU/L] in group B was significantly higher than those in group N [（2.72±0.51）mIU/L] and group A [（2.78±0.42） mIU/L, all P〈0.05]. The serum TSH level in group B [（2.99±0.57） mIU/L] was still higher than those in group N [（2.48±0.68） mIU/L] by 8 to 10 weeks postpartum （P〈0.05 ）. Multiple stepwise regression analysis revealed that TSH, TPOAb, and urine iodine levels of mothers were independently related to TSH of their infants. Conclusio
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2010年第11期931-935,共5页
Chinese Journal of Endocrinology and Metabolism
关键词
妊娠
甲状腺
自身抗体
甲状腺功能
婴儿
Pregnancy
Thyroid
Autoantibodies
Thyroid function
Newborn
