妊娠期糖尿病高危孕妇血清中T3、T4、FT3、FT4、TSH、TPOAb及TGAb含量变化分析

Analysis of content change of the levels T3,T4,FT3,FT4,TSH,TPOAb and TGAb in the serum of pregnant women with high risk of gestational diabetes

目的探讨妊娠期糖尿病高危孕妇血清中三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、抗甲状腺过氧化物酶抗体(TPOAb)及抗甲状腺球蛋白抗体(TGAb)的含量变化。方法选取2014年1月至2015年12月收治的孕妇110例进行回顾性分析,经GDM高危因素分析调查及口服糖耐量试验(OGTT)后分为正常对照组和研究组。依据OGTT试验结果,再将研究组孕妇分成正常糖耐量组(NGT)、妊娠期糖耐量受损组(IGGT)、妊娠糖尿病组(GDM)。比较四组孕妇血清T3、T4、FT3、FT4、TSH水平,血清TPOAb及TGAb抗体含量,以及家族史对孕妇自身免疫抗体的影响。结果 GDM组孕妇血清中的FT3、FT4的下降程度低于其他三组(P<0.05);GDM孕妇血清中的FT4在小于6.4 pmol/L的浓度分布占68.4%,明显高于其他三组(P<0.05);正常对照组TPOAb和TGAb阳性总比率明显低于GDM高危因素孕妇组和GDM孕妇组(P<0.05);在有GDM高危因素孕妇和GDM孕妇中,同时有2种家族史的抗体阳性率和自身抗体阳性率明显高于单独有1种家族史和无家族史的孕妇(P<0.05)。结论在GDM高危孕妇中进行T3、T4、FT3、FT4、TSH、TPOAb及TGA检测意义重大,有助于GDM的早期诊断、早期干预治疗。

Objective To discuss the content change of the levels of three iodine thyroid gland（ T3）,thyroxine（ T4）,free three iodine thyroid gland（ FT3）,free thyroid hormone（ FT4）,thyroid stimulating hormone（ TSH）,anti thyroid peroxidase antibody（ TPOAb） and anti thyroid globulin antibody（ TGAb） in the serum of pregnant women with high risk of gestational diabetes. Methods 110 cases of pregnant woman in our hospital from January 2014 to December 2015 were selected,which were divided into normal control group and control group after GDM high risk factor analysis survey and oral glucose tolerance test（ OGTT）. Based on the results of OGTT test,the study group pregnant women were divided into normal glucose tolerance group（ NGT）,gestational impaired glucose tolerance group（ IGGT）,gestational diabetes mellitus group（ GDM）. Results The value of FT3 and FT4 in serum of GDM pregnant women fell most obviously than the other three groups,and the difference was statistically significant（ P 〈 0. 05）. In less than 6. 4 pmol/L,the level of FT4 in serum of GDM pregnant women,the concentration distribution accounted for 68. 4%,significantly higher than the other three groups（ P 〈 0. 05）. The total percentage accounted with women in the normal control group were significantly lower than women with GDM and the women which had the high risk factors and women in the GDM pregnant（ P〈 0. 05）. The antibody positive rate and the rate of autoantibodies positive 2 family history were significantly higher than the 1 family history and no family history both in the high risk factors of GDM pregnant women and in GDM pregnant women. Conclusion The detection significance of T3,T4,FT3,FT4,TGA,TPOAb,TSH and GDM in high-risk pregnant women is important,which is helpful to the early diagnosis,early intervention and treatment of GDM.