妊娠各期血清甲状腺激素及TPO-Ab水平变化及临床意义

The changes and the clinical significances of serum thyroid hormone and TPO-Ab levels during different pregnant stage

目的:探讨血清甲状腺激素及甲状腺过氧化物酶抗体(TPO-Ab)水平在妊娠早、中、晚期变化及临床意义。方法:回顾性收集2018年1年—2019年1月本院行产前检查孕妇106例临床资料(孕妇组),其中妊娠早期25例、中期38例、晚期43例;同期本院体检健康非妊娠女性106例为对照组。分别在孕妇组产前检查时、对照组体检时取血清检测甲状腺激素、TPO-Ab并比较。结果:孕妇组妊娠早期、中期TSH水平低于对照组,妊娠早、中、晚期FT3、FT4水平低于对照组,TPO-Ab水平高于对照组(均P<0.05);孕妇组妊娠晚期TPO-Ab阳性率低于早期(P<0.05)。Spearman相关性分析显示,孕妇妊娠早、中期血清TSH与TPO-Ab阳性率呈正相关(P<0.05)。结论:孕妇妊娠早、中、晚期存在血清甲状腺激素及TPO-Ab水平改变,提示对临床评估孕期甲状腺疾病可能有一定作用。

Objective:To investigate the changes and the clinical significances of serum thyroid hormone and thyroid peroxidase antibody(TPO-Ab)levels of pregnant women during the first,second,and third trimester of pregnancy.Methods:The clinical data of 106 pregnant women in group A from January 2018 to January 2019 were retrospectively analyzed,which included 25 women during the first trimester of pregnancy in group A1,38 women during the second trimester of pregnancy in group A2,and 43 women during the third trimester of pregnancy in group A3.And 106 healthy non-pregnant women were selected in group B during the same period.Serum of these women was collected for detecting their levels of thyroid hormone and TPO-Ab.The levels of the thyroid hormone and TPO-Ab of the women were compared between the groups.Results:The TSH level of the women in group A1 and group A2 were significant lower than that of the women in group B.The FT3 and FT4 levels of the women in group A1,group A2,and group A3 were significant lower than those of the women in group B,but the TPO-Ab level of the women in group A1,group A2,and group A3 was significant higher than that of the women in group B(all P<0.05).The positive rate of TPO-Ab of the women in group A3 was significant lower than that of the women in group A1(P<0.05).Spearman correlation analysis showed that serum TSH level of the pregnant women in group A1 and group A2 was positively correlated with their positive rate of TPO-Ab(P<0.05).Conclusion:Serum thyroid hormone and TPO-Ab levels of pregnant women during the first,second,and third trimester of pregnancy are altered y,which may play a role for assessing the thyroid disease of women during pregnancy.