妊娠期甲状腺功能低下诊断中甲状腺过氧化物酶抗体检测的应用研究

Application of serum thyroid peroxidase antibody in diagnosis of hypothyroidism in pregnancy

目的分析血清甲状腺过氧化物酶抗体(TPOAb)测定应用于妊娠期甲状腺功能低下诊断的临床效果。方法于2017年1月至2019年1月在三门峡市中心医院进行产检的初孕妇中选取70例,均采集空腹外周静脉血进行促甲状腺激素(TSH)、TPOAb和游离甲状腺素(FT4)检测,观察不同妊娠时期孕妇的各指标水平及不同TPOAb浓度孕妇的妊娠结局。结果妊娠早期组的TSH、TPOAb水平均显著低于妊娠中期组,FT4浓度高于妊娠中期组,差异均有统计学意义(P<0.05)。70例孕妇中检出TPOAb阳性20例,TPOAb阴性50例,TPOAb阳性组的TSH异常率为25.0%,不良妊娠结局发生率为45.0%,均显著高于TPOAb阴性组的6.0%和12.0%,对比差异有统计学意义(P<0.05)。结论TPOAb与甲状腺功能异常具有较大关系,能够较好地反映孕妇的甲状腺功能状况,可将其作为临床诊断妊娠期甲状腺功能低下的重要辅助指标。

Objective To analyze the clinical effect of serum thyroid peroxidase antibody(TPOAb)in the diagnosis of hypothyroidism in pregnancy.Methods From January 2017 to January 2019,70 cases of pregnant women who underwent labor examination in our hospital were selected.All the fasting peripheral venous blood was collected for testing of thyroid stimulating hormone(TSH),TPOAb and free thyroxine(FT4).The pregnancy outcomes of pregnant women with different levels of indicators and concentrations of TPOAb in different pregnancy periods were observed.Results TSH and TPOAb levels in the early pregnancy group were significantly lower than those in the second trimester group,and FT4 concentrations were higher than those in the second trimester group,with statistically significant differences(P<0.05).Among the 70 pregnant women,20 were TPOAb-positive and 50 were TPOAb-negative,respectively.The abnormal rate of TSH in the TPOAb-positive group was 25.0%and the incidence rate of adverse pregnancy outcome was 45.0%,both of which were significantly higher than that in the TPOAb-negative group(6.0%and 12.0%respectively),with significant differences(P<0.05).Conclusion TPOAb has a great relationship with thyroid dysfunction,which can well reflect the thyroid function of pregnant women,and can be used as an important auxiliary index for the clinical diagnosis of hypothyroidism in pregnancy.