妊娠期甲状腺激素水平、抗甲状腺过氧化物酶抗体变化及两者相关性分析

Levels of Thyroid Hormone and Antithyroid Peroxidase Antibody During Pregnancy: a Correlative Analysis

目的研究孕妇妊娠期甲状腺激素、抗甲状腺过氧化物酶抗体水平变化,并分析两者的相关性,为临床监测孕期妇女甲状腺水平提供参考。方法 914例孕妇分成妊娠早期(T1)、妊娠中期(T2)、妊娠晚期(T3)3组,选取同期体检的20~45岁的健康非妊娠妇女100人作为对照组,比较各组的FT3、FT4、TSH以及Tg Ab、TPOAb水平,确定不同妊娠时期的参考范围,并分析FT3、FT4、TSH与TPOAb的相关性。结果不同妊娠期孕妇的FT3、FT4、TSH水平及血清Tg Ab、TPOAb水平差异均有统计学意义(P<0.05);TPOAb阴性妊娠期妇女血清TSH与TPOAb水平呈现显著负相关(r=-0.143,P<0.05)。结论各孕期孕妇的甲状腺激素水平明显降低,随孕周增加,逐渐恢复正常水平;TPOAb阴性妊娠期妇女血清TSH与TPOAb水平呈负相关。

Objective To study the correlation of the levels of thyroid hormone and antithyroid peroxidase antibody（ antiTPOAb） in pregnant women during pregnancy so as to provide reference for clinical monitoring of thyroid level in pregnant women.Methods 914 pregnant women were divided into early pregnancy（ T1） group,middle pregnancy（ T2） group and late pregnancy（ T3） group. In the same period,100 healthy non-pregnancy women whose ages were between 20 and 45 were chosen as a control group. FT3,FT4,TSH,Tg Ab and anti-TPOAb levels were compared to determine the reference range of different pregnancy period. The correlations between FT3,FT4,TSH and anti-TPOAb were explored. Results There were statistically significant difference in FT3,FT4,TSH,Tg Ab and anti-TPOAb levels among three groups of pregnant women（ P 〈0. 05）. There was a negative correlation between serum TSH and anti-TPOAb in anti-TPOAb-negative pregnant women（ r =-0. 143,P 〈0. 05）. Conclusions The levels of thyroid hormones in pregnant women were significantly decreased and gradually increased to normal level with the increase of gestational age. There was a negative correlation between serum TSH and anti-TPOAb level in anti-TPOAb negative pregnant women.