摘要
目的孕期合并甲状腺疾病的孕妇检测筛查中,血清促甲状腺激素(thyroid stimulating hormone,TSH)、抗甲状腺过氧化物酶抗体(antithyroid peroxidase autoantibody,TPOAb)和抗甲状腺球蛋白抗体(anti-thyroglobulin antibodies,TGAb)具有指导临床诊断与治疗的作用。本研究旨在观察TSH、TGAb和TPOAb在孕妇合并甲状腺疾病的改变,分析其在临床诊断中的作用。方法选取2013-04-01-2017-07-01北部战区总医院住院治疗的120例孕妇合并有甲状腺增生结节的患者为病例组;同期选择110名健康孕妇作为对照组,均进行常规孕妇产前理化检查确诊无甲状腺疾病、无既往或家族史,通过化学发光法检测两组人群TSH、TGAb和TPOAb水平。采用ROC分析TSH、TGAb、TPOAb联合试验对孕妇合并甲状腺疾病筛查的临床意义。结果甲状腺病例组和对照组TSH水平分别为(3.96±0.87)和(1.56±0.54)μIU/mL,t=2.014,P=0.046;TGAb水平分别为(21.88±5.11)和(3.56±0.88)U/mL,t=10.365,P<0.001;TPOAb水平分别为(42.±4.18)和(6.69±0.98)IU/mL,t=20.456,P<0.001。病例组和对照组TSH阳性表达率分别为78.3%和16.3%,χ~2=123.64,P<0.001;TGAb阳性表达率分别为89.1%和12.7%,χ~2=142.68,P<0.001;TPOAb阳性表达率分别为80.8%和14.5%,χ~2=136.95,P<0.001。三项联合因子曲线下面积AUC=0.964,大于三个指标各自的AUC值,但差异无统计学意义,P>0.05。结论血清TSH、TPOAb和TGAb在孕妇早期合并甲状腺疾病时升高,但三项指标联合筛查的临床作用不明显,还不能认为联合检测的筛查效率高于单项检测。
OBJECTIVE In the screening of pregnant women with thyroid disease,serum thyroid stimulating hormone(TSH),antithyroid peroxidase autoantibody(TPOAb)and anti-thyroglobulin antibodies(TGAb).It has the role of guiding clinical diagnosis and treatment.The aim of this study was to investigate the changes in TSH,TGAb,and TPOAb in pregnant women with thyroid disease and to analyze their role in clinical diagnosis.METHODS A total of 120 pregnant women hospitalized in our hospital from April 1,2013 to July 1,2017 were enrolled in the case group with thyroid hyperplasia.In the same period,110 healthy pregnant women were selected as the control group,and all the routine prenatal physical and chemical examinations were performed.The levels of TSH,TGAb and TPOAb were detected by chemiluminescence method in the absence of thyroid disease,no previous or family history.The clinical significance of the combined test of TSH,TGAb and TPOAb in the screening of pregnant women with thyroid disease was analyzed by ROC.RESULTS The TSH levels in the thyroid case group and the control group were(3.96±0.87)and(1.56±0.54),t=2.014,P=0.046.The TGAb levels were(21.88±5.11)and(3.56±0.88),t=10.365,P<0.001.TPOAb levels were(42±4.18)and(6.69±0.98),t=20.456,P<0.001.The positive expression rates of TSH in case group and control group were 78.3%and 16.3%,respectively,χ~2=123.64,P<0.001;the positive expression rates of TGAb were 89.1%and 12.7%,χ~2=142.68,P<0.001.The positive expression rates of TPOAb were 80.8%and 14.5%,χ~2=136.95,P<0.001.The area under the three joint factor curves was AUC=0.964,which was greater than the AUC values of the three indicators,but the difference was not statistically significant,P>0.05.CONCLUSIONS Serum TSH,TPOAb and TGAb are elevated in early pregnancy with thyroid disease,but the combined advantages of the three indicators are not obvious.It is not considered that the screening efficiency of the combined test was higher than that of the single test.
作者
杨彬婕
侯丹
YANG Bin-jie;HOU Dan(Department of Physical Examination Center,Northern Theater General Hospital,Shenyang110000,P.R.China)
出处
《社区医学杂志》
2019年第24期1572-1575,共4页
Journal Of Community Medicine
