TSAb检测对妊娠合并Graves病孕妇的临床意义

Study on detection of TSAb in pregnancy complicated with diffuse goiter with hyperthyroidism and its clinical significance

目的探讨甲状腺兴奋性抗体(TSAb)检测对妊娠合并弥漫性甲状腺肿伴甲状腺功能亢进症(Graves病)患者的临床意义。方法将33例TSAb阳性的妊娠合并Graves病的患者列为观察1组,30例TSAb阴性的妊娠合并Graves病的患者列为观察2组,30例正常妊娠者列为对照组。回顾分析三组的妊娠期母体并发症及新生儿评分等妊娠结局。结果观察1组中出现早产、中重度妊娠期高血压疾病、产后出血并发症概率明显高于观察2组及对照组(P<0.05)。观察2组上述三种并发症出现概率与对照组比较无统计学意义(P>0.05)。妊娠合并Graves病的两组中的新生儿评分、新生儿体质量明显低于对照组(P<0.05)。观察1组中新生儿评分及新生儿体质量低于观察2组(P<0.05)。结论妊娠合并Graves病对妊娠结局有不良影响。TSAb阳性的妊娠合并Graves病患者高危妊娠的发生率更高。加强对甲状腺功能及TSAb的监测,对不良妊娠结局的发生有预测及指导意义。

Objective To study the detection of thyroid stimulating antibody （TSAb） in pregnancy complicated with diffuse goiter with hyperthyroidism （Graves disease） and its clinical significance. Methods In the study, subjects were divided into Group A （ n = 33, positive TSAb, in pregnancy complicated with Graves disease） , Group B （ n = 30, negative TSAb, in pregnancy complicated with Graves disease） and Group C （ n = 30, in normal pregnancy）. Retrospective analysis was done on the three groups so that the comparison on complications and outcome would be made. Results The probabilities of premature delivery, preeclampsia, postpartum hemorrhage were significantly higher in Group A than in Group B or C （ P 〈 0.05 ） , and there were no differences in the probabilities between Group B and Group C （ P 〉 0.05 ）. The neonatal score and body mass of Group A or Group B were significantly lower than that of Group C （ P 〈 0.05 ） , and the two indexes of Group A were significantly lower than that of Group B （ P 〈 0.05 ）. Conclusion Pregnancy with Graves disease badly influences the outcome of pregnancy. The rate of high risk pregnancy is higher in those with positive TSAb complicated with Graves disease. To strengthen the monitoring of thyroid function and TSAb is of clinical significance in the prediction of adverse pregnancy outcome.