血清Hcy和TPO-Ab水平与妊娠期亚临床甲状腺功能减退症患者妊娠结局的关系分析

Analysis of the relationship between serum Hcy and TPO-Ab levels and pregnancy outcome in patients with subclinical hypothyroidism during pregnancy

目的分析血清同型半胱氨酸(Hcy)和甲状腺过氧化物酶抗体(TPO-Ab)水平在妊娠期亚临床甲状腺功能减退症患者中的应用,观察其妊娠结局。方法以2020年4月~2022年4月收治50例孕产妇为研究对象,依据孕期是否合并亚临床甲状腺功能减退症分为试验组(25例)与对照组(25例),采集两组静脉血,测定其血清Hcy与TPO-Ab水平,评估其妊娠结局。结果试验组血清Hcy和TPO-Ab水平高于对照组(P<0.05),试验组母体及胎儿/新生儿并发症发生率与对照组比较,差异无统计学意义(P>0.05);试验组Hcy阳性孕产妇妊娠期高血压疾病高于Hcy阴性(P<0.05);试验组TPO-Ab阳性患者胎儿宫内窘迫发生率高于TPO-Ab阴性患者(P<0.05)。结论血清Hcy阳性及TPO-Ab阳性不利于妊娠期亚临床甲状腺功能减退患者的妊娠结局,因此在妊娠早期应积极展开甲状腺功能检测,尤其是Hcy与TPO-Ab筛查,做好及时诊断及预防,以此降低不良妊娠结局的发生。

Objective To analyze serum homocysteine(Hcy)and thyroid peroxidase antibody(TPO-Ab)levels in patients with subclinical hypothyroidism during pregnancy to observe pregnancy outcomes.Methods Fifty pregnant women admitted to our hospital from April 2020 to April 2022 were studied and divided into the test group(25 cases)and the control group(25 cases)according to whether they had subclinical hypothyroidism during pregnancy.Venous blood was collected from both groups and their serum Hcy and TPO-Ab levels were measured to assess their pregnancy outcomes.Results Serum Hcy and TPO-Ab levels were higher in the test group than in the control group(P<0.05).There was no statistically significant difference in the incidence of maternal and fetal/neonatal complications in the test group compared with the control group(P>0.05);the maternal hypertensive disorders of pregnancy were higher in the test group of Hcy-positive women than in Hcy-negative women(P<0.05);and the incidence of intrauterine distress was higher in TPO-Ab-positive patients than in TPO-Ab-negative patients in the test group(P<0.05).Conclusion Positive serum Hcy and TPO-Ab are detrimental to the pregnancy outcome in patients with subclinical hypothyroidism in pregnancy.Therefore,thyroid function tests,especially Hcy and TPO-Ab screening,should be actively performed in early pregnancy for timely diagnosis and prevention,so as to reduce the occurrence of adverse pregnancy outcomes.