摘要
目的探讨妊娠早期甲状腺自身抗体阳性与不良妊娠结局的关系。方法回顾性分析2018年1月至2019年6月于首都医科大学附属北京安贞医院妇产科门诊建档产前检查,首次产前检查孕周≤13周且妊娠早期甲状腺功能正常的449例孕妇的临床资料,根据甲状腺自身抗体检测结果,将孕妇分为阳性组[甲状腺过氧化物酶抗体(TPO-Ab)和/或甲状腺球蛋白抗体(TG-Ab)阳性]和阴性组(TPO-Ab和TG-Ab阴性),比较2组促甲状腺激素(TSH)、游离甲状腺激素(FT4)、血脂水平及妊娠结局的差异。结果449例孕妇中,甲状腺自身抗体阳性81例(阳性组),其余368例均为甲状腺自身抗体阴性(阴性组)。阳性组TSH水平高于阴性组[(1.9±0.9)m IU/L比(1.5±0.9)m IU/L],FT4水平低于阴性组[(10.7±1.4)pmol/L比(11.1±1.6)pmol/L],差异均有统计学意义(均P<0.05)。2组三酰甘油、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平差异均无统计学意义(均P>0.05)。阳性组妊娠期贫血发生率低于阴性组,早产、羊水过少发生率均高于阴性组[12.3%(10/81)比5.7%(21/368)、11.1%(9/81)比5.2%(19/368)],差异有统计学意义(均P<0.05)。2组非自然分娩、胎儿窘迫、低出生体质量儿、巨大儿比例比较,差异均无统计学意义(均P>0.05)。结论甲状腺自身抗体阳性对妊娠结局存在不良影响。
Objective To explore the association between thyroid autoantibody positive and adverse pregnancy outcomes.Methods From January 2018 to June 2019,clinical data of 449 pregnant women who established dossiers and underwent obstetric examination with the gestational age≤13 weeks at the first obstetric examination and normal thyroid function in the first trimester in Beijing Anzhen Hospital,Capital Medical University was retrospectively analyzed.According to the results of thyroid autoantibody test,they were divided into positive group[thyroid peroxidase antibody(TPO-Ab)and/or thyroglobulin antibody(TG-Ab)positive]and negative group(TPO-Ab and TG-Ab negative).The differences in thyroid stimulating hormone(TSH),free thyroid hormone(FT4),blood lipid levels and pregnancy outcomes between the two groups were compared.Results Among449 pregnant women,81 cases were thyroid autoantibody positive(positive group),and other 368 cases were thyroid autoantibody negative(negative group).The level of TSH in positive group was higher than that in negative group[(1.9±0.9)m IU/L vs(1.5±0.9)m IU/L]and the level of FT4 in positive group was lower than that in negative group[(10.7±1.4)pmol/L vs(11.1±1.6)pmol/L](both P<0.05).There were no significant differences in levels of triglyceride,total cholesterol,low-density lipoprotein cholesterol and high-density lipoprotein cholesterol(all P>0.05).The incidence of pregnancy anemia in positive group was lower than that in negative group,and incidences of premature delivery and oligohydramnios in positive group were higher than those in negative group[12.3%(10/81)vs 5.7%(21/368),11.1%(9/81)vs 5.2%(19/368)](all P<0.05).There were no significant differences in incidences of unnatural delivery,fetal distress,low birth weight infants and giant infants(all P>0.05).Conclusion Thyroid autoantibody positive has adverse effect on pregnancy outcomes.
作者
赵智宏
朴春梅
王克芳
Zhao Zhihong;Piao Chunmei;Wang Kefang(Department of Obstetrics and Gynecology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)
出处
《中国医药》
2021年第11期1696-1699,共4页
China Medicine
基金
国家自然科学基金(81770468)
北京市医院管理局临床技术创新项目(XMLX201828)。
