不同妊娠期甲状腺自身抗体筛查结果分析

Analysis of autoantibody screening results of different gestational thyroid

目的 通过对不同妊娠期甲状腺自身抗体的阳性率调查,并结合文献探讨抗甲状腺自身抗体阳性对母婴的影响,从而提高对相应疾病的诊治.方法 549例不同妊娠期妇女分为妊娠早期组178例,妊娠中期组192例,妊娠晚期组179例,采用电化学发光法检测甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TGAb）、促甲状腺激素受体抗体（TRAb）、促甲状腺激素（TSH）,并与200例体检健康者（对照组）比较.结果 妊娠早期组TPOAb阳性率为18.54％ （33/178）,TGAb阳性率为19.66％ （35/178）,TRAb阳性率为0.56％ （1/178）,妊娠中期组TPOAb阳性率为15.62％（30/192）,TGAb阳性率为16.15％（31/192）,TRAb阳性率为0.52％ （1/192）,妊娠晚期组TPOAb阳性率为16.20％ （29/179）,TGAb阳性率为16.76％ （30/179）,TRAb阳性率为0.56％（1/179）.妊娠早期组TPOAb、TGAb中位数及阳性率高于妊娠中期组、妊娠晚期组和对照组,差异有统计学意义（P＜0.01）.妊娠中期组TPOAb、TGAb中位数及阳性率高于妊娠晚期组和对照组,差异有统计学意义（P＜0.01）.结论 应当重视妊娠期甲状腺自身抗体的发生率,对高危孕妇应采取必要的干预.

Objective To discuss the effect of autoantibodies positive on maternal and infant combined with literature by investigating the positive rate of different gestational thyroid autoantibodies,so as to improve the diagnosis and treatment of diseases.Methods A total of 549 cases of pregnant women were divided into early pregnancy group （178 cases）,middle pregnancy group（192 cases）,late pregnancy group （179 cases）.The level of thyroid peroxidase antibody （TPOAb）,thyroglobuhn antibody （TGAb）,thyroid stimulating hormone receptor antibody （TRAb）,thyroid stimulating hormone （TSH） were determined by electrochemiluminescence.And compared with 200 healthy people （control group）.Results The positive rate of TPOAb was 18.54% （33/178）,the positive rate of TGAb was 19.66% （35/178）,the positive rate of TRAb was 0.56% （1/178） in early pregnancy group.The positive rate of TPOAb was 15.62% （30/192）,the positive rate of TGAb was 16.15% （31/192）,the positive rate of TRAb was 0.52% （1/192） in middle pregnancy group.The positive rate of TPOAb was 16.20% （29/179）,the positive rate of TGAb was 16.76% （30/179）,the positive rate of TRAb was 0.56% （1/179） in late pregnancy group.The median TPOAb TGAb and the positive rate in early pregnancy group was higher than that in middle pregnancy group,late pregnancy group and control group,the difference was statistically significant （P 〈 0.01）.The median TPOAb,TGAb and the positive rate in middle pregnancy group was higher than that in late pregnancy group and control group,the difference was statistically significant （P 〈 0.01）.Conclusion More attention should be paid to gestational thyroid autoantibodies incidence,take the necessary intervention should be of high risk pregnant women.