脐血甲状腺过氧化物酶抗体检测的临床意义

Clinical significance of thyroid peroxidase antibody detection in umbilical cord blood

目的探讨脐血甲状腺过氧化物酶抗体（thyroid peroxidase antibody,TPOAb）检测的临床意义。方法通过留取脐静脉血检测甲状腺功能,分析脐血TPOAb与孕母甲状腺功能、新生儿甲状腺功能及短期生长发育之间的关系。结果 1）新生儿脐血TPOAb阳性与母亲的甲状腺功能异常、母亲血清TSH及TPOAb异常有关（χ2值分别为48.55,13.716,251.1,P均〈0.001）。2）脐血TPOAb阳性的新生儿,其脐血FT4水平较脐血TPOAb阴性者低,P〈0.05。3）脐血TPOAb阳性对新生儿的出生体重（OR值=3.239,95%CI：1.072-9.781,P〈0.05）、出生身长（OR值=9.483,95%CI：3.228-27.35,P〈0.05）和出生头围（OR值=3.669,95%CI：2.34-5.75,P〈0.05）均有影响。4）脐血TPOAb阳性对患儿5月龄时的体重（OR值=3.827,95%CI：1.396-10.492,P〈0.05）和个人-社交能有影响（OR值=2.8,95%CI：1.178-6.654,P〈0.05）。结论脐血TPOAb阳性与母亲孕期异常的甲状腺功能有关,并对子代的体格和智能发育产生影响,应对妊娠期甲状腺功能异常孕母的子代进行脐血TPOAb检测。

Objective To investigate the clinical significance of thyroid peroxidase antibody （TPOAb） detection in umbilical cord blood. Methods The thyroid function of umbilical cord blood was saved and tested, the relationship between TPOAb of umbilical cord blood and the thyroid function of mother and neonate, and its effects on neonatal short-term growth was analysed. Results 1） The positive neonatal cord blood TPOAb were related to maternal abnormal thyroid function,abnormal serum TSH and abnormal TPOAb of mother （x^2 = 48.55,13. 716,251. 1, respectively, P〈0. 001）. 2） The umbilical cord blood FT4 level of the neonates with positive umbilical cord blood TPOAb was lower than those with negative TPOAb neonates （P〈0.05）. 3） Positive umbilical cord blood TPOAb had effects on neonatal birth weight（OR= 3. 239,95%CI：1. 072-9. 781,P〈0.05） ,birth length （OR=9. 483,95%CI：3. 228-27.35,P〈0.05） and head circumference（OR=3. 669,95%CI：2.34-5.75,P〈0.05）. 4）The neonates with positive cord blood TPOAb had effects on their weight （OR=3. 827,95%CI：1. 396-10. 492,P〈0.05） and personal-social ability（OR=2.8,95%CI：1. 178-6. 654,P〈0.05） when they were 5 months old. Conclusions Positive umbilical cord blood TPOAb is related to maternal abnormal thyroid function during pregnancy and can affect the physique and intelligence development of the neonates, therefore, strengthening the screening of thyroid function and thyroid autoantibody of gestational mother and closely follow-up those positive umbilical cord blood TPOAb neonates should be advocated.