妊娠早期孕妇TPO-Ab、TG-Ab与妊娠结局的相关性分析

Correlation analysis of TPO-Ab and TG-Ab and the pregnancy outcome of women in early pregnancy

目的比较妊娠早期甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPO-Ab)、甲状腺球蛋白抗体(thyroglobulin antibody,TG-Ab)不同表达状态孕妇的妊娠结局,以减少不良母婴结局。方法测定100例妊娠早期孕妇的血清TPO-Ab、TG-Ab水平,根据检测结果将其分为TPO-Ab阳性组、TG-Ab阳性组、TPO-Ab与TG-Ab均阳性组(双阳性组)、TPO-Ab与TG-Ab均阴性组(双阴性组)。比较入组时、妊娠晚期,4组孕妇甲状腺功能变化情况;记录并比较4组孕妇流产、早产、妊娠高血压等不良妊娠结局及围生儿低体重出生儿、吸入综合征等并发症情况。结果妊娠晚期,4组孕妇间仅FT_(4)和(或)FT_(3)降低、仅TSH升高、TSH升高且FT_(4)和(或)FT_(3)降低等甲状腺功能异常发生率,差异均有统计学意义(P<0.05)。4组孕妇间流产、早产、妊娠高血压的发生率差异有统计学意义(P<0.05),4组围生儿低体重出生儿、吸入综合征发生率差异无统计学意义(P>0.05)。结论妊娠早期TPO-Ab、TG-Ab双阳性的孕妇,在妊娠晚期甲状腺功能异常及不良妊娠结局发生率较高。

Objective To compare the pregnancy outcomes of pregnant women with different expressions of thyroid peroxidase antibody(TPO-Ab)and thyroglobulin antibody(TG-Ab)in early pregnancy in order to reduce poor maternal and infant outcomes.Methods The serum levels of TPO-Ab and TG-Ab were measured in 100 early pregnant women.According to the detection results,they were divided into TPO-Ab positive group,TG-Ab positive group,TPO-Ab and TG-Ab positive group(double positive group)and TPO-Ab and TG-Ab negative group(double negative group).The changes of thyroid function in the four groups of pregnant women at the time of enrollment and in the third trimester of pregnancy were compared.The poor pregnancy outcomes of pregnant women such as abortion,premature delivery and pregnancy induced hypertension and complications of perinatal infants such as low birth weight and inhalation syndrome in the four groups were recorded and compared.Results In the third trimester of pregnancy,there were statistically significant differences in the incidence of thyroid dysfunction such as the decrease of FT_(4) and(or)FT_(3),the increase of TSH and the increase of TSH combined with the decrease of FT_(4) and(or)FT_(3) among the four groups of pregnant women(P<0.05).There were statistically significant differences in the incidences of abortion,premature delivery and pregnancy induced hypertension among the four groups of pregnant women(P<0.05).There were no statistically significant differences in the incidences of low birth weight and inhalation syndrome among the four groups of perinatal infants(P>0.05).Conclusions The pregnant women with TPO-Ab and TG-Ab positive in the first trimester of pregnancy had a higher incidence of thyroid dysfunction and adverse pregnancy outcomes in the third trimester of pregnancy.