摘要
目的探讨妊娠期促甲状腺激素(TSH)水平异常与甲状腺过氧化物酶抗体(TPOAb)水平变化之间的关系,并分析并发症的危险因素。方法选取上海市宝山区罗店医院2016年1月-2018年12月期间收治的妊娠期TSH异常孕妇459例,分为三组,检测研究对象的TSH及TPOAb水平变化情况,并分析其发生妊娠相关并发症的危险因素。结果观察组孕妇的血清TSH和TPOAb水平均显著高于对照组,且高于正常参考值范围。在观察组孕妇中,TPOAb阳性孕妇的血清TSH水平均显著高于TPOAb阴性组孕妇的血清TSH水平,差异均有统计学意义(P<0.05)。观察组孕妇的各类并发症的发生率均显著高于对照组(P<0.05)。在观察组患者中,A组孕妇的糖耐量异常和贫血发生率显著高于B组、新生儿窒息发生率显著低于B组;C组孕妇的糖耐量异常、贫血、胎盘早剥、子痫前期及新生儿窒息的发生率均显著高于A组;C组孕妇的糖耐量异常、贫血及胎盘早剥发生率均显著高于B组,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,甲状腺病史、伴有疾病、不遵医服药、分娩前有不良情绪、妊娠期TPOAb阳性、妊娠早期TSH异常及妊娠中晚期TSH异常是TSH异常孕妇发生产科并发症的危险因素。结论妊娠期TSH水平异常与TPOAb水平变化具有明显相关性;妊娠期TSH异常孕妇产科并发症的发生率较高,受多种因素综合影响。
OBJECTIVE To investigate the relationship between thyroid stimulating hormone(TSH)leveland changes of thyroid peroxidase antibody(TPOAb)level during pregnancy,and to analyze the risk factors of complications. METHODS 459 pregnant women with abnormal TSH were divided into 3 groups. The levels of TSH and TPOAb in all subjects were detected,and the risk factors of pregnancy-related complications were analyzed. RESULTS The serum TSH and TPOAb levels in the observation group were significantly higher than the control group and higher than the normal reference value range. In the observation group,the serum TSH levels of TPOAb-positive pregnant women were significantly higher than TPOAb-negative pregnant women(P<0.05). The incidence of various complications in the observation group was significantly higher than the control group(P<0.05). The incidence of abnormal glucose tolerance and anemia in group A was significantly higher than group B and neonatal asphyxia was significantly lower than group B. The incidence of abnormal glucose tolerance,anemia,placental abruption,preeclampsia and neonatal asphyxia in group C was significantly higher than group A. The incidence of abnormal glucose tolerance,anemia and placental abruption in group C was significantly higher than group B. The difference was statistically significant(P<0.05). Logistic regression analysis showed that the risk factors of obstetric complications in pregnant women with TSH abnormalities included history of thyroid disease,accompanied by diseases,non-compliance with medical treatment,bad mood before delivery,positive TPOAb during pregnancy,abnormal TSH in early pregnancy and abnormal TSH in middle and late pregnancy(P<0.05). CONCLUSION The abnormal TSH level during pregnancy was significantly correlated with the change of TPOAb level,and the incidence of obstetric complications was higher,which was affected by several factors.
作者
赵传志
吴永梅
ZHAO Chuan-zhi;WU Yong-mei(Luodian Hospital,Baoshan District,Shanghai,201908,China)
出处
《中国初级卫生保健》
2019年第12期44-46,共3页
Chinese Primary Health Care
