摘要
目的研究妊娠中晚期孕妇甲状腺功能异常及自身抗体阳性的患病率，探讨在孕妇群体中进行甲状腺筛查的必要性。方法研究对象为2006年6月至2008年2月期间在上海交通大学附属第一人民医院就诊的妊娠中晚期孕妇，以问卷调查方式采集病史资料，根据孕妇是否有甲状腺疾病既往史、家族史或其他相关疾病既往史，分为高甲状腺疾病风险组（高风险组）和低甲状腺疾病风险组（低风险组）。对所有孕妇检测血清FT_3、FT_4、TSH、甲状腺过氧化物酶抗体（TPOAb）和促甲状腺激素受体抗体水平。结果共筛查孕妇2101名，发现有各种甲状腺功能异常或甲状腺抗体阳性712例（33．89％）。高风险组孕妇中有较高比例的甲状腺功能异常，而低风险组1983名孕妇中亦有2．27％（45例）诊断为甲状腺功能减退，11．60％（230例）为亚临床甲状腺功能减退，0．20％（4例）为甲状腺功能亢进，1．06％（21例）为亚临床甲状腺功能亢进，6．45％（128例）为低甲状腺素血症，10．74％（213例）甲状腺功能正常但TPOAb阳性。在TPOAb阳性孕妇中，甲状腺功能异常者更多见。其中79．74％甲状腺功能异常或TPOAb阳性孕妇经本次筛查发现。结论妊娠中晚期孕妇中进行甲状腺筛查可发现33．89％孕妇存在甲状腺功能异常或TPOAb阳性，TPOAb阳性孕妇出现甲状腺功能异常的患病率增加。如果仅对高风险孕妇进行甲状腺筛查，则可能导致高达79．74％患者漏诊。
Objective To investigate the prevalence of thyroid disorders and positive thyroid autoantibodies, and evaluate the necessity for universal thyroid screening during the second and third trimesters of pregnancy. Methods The pregnant women during the second and third trimesters who visited Shanghai Jiaotong University Affiliated First People＇s Hospital between June 2006 and February 2008 were chosen for thyroid screening by determining serum free triiodothyronine, free thyroxine, thyrotropin, thyroid pero^idase antibody （ TPOAb ）, and thyrotropin receptor antibody. A personal and family history of thyroid disease and other autoimmune diseases was investigated by questionnaire. The pregnant women were divided into high risk or low risk groups for thyroid disease based on their personal or family histories. Results A total of 2 101 pregnant women were screened, 712 （33.89%） of them were identified to suffer from thyroid disorders or with positive thyroid autoantibody. The prevalence of thyroid dysfunction was increased in high risk group. While in low risk group（ n= 1 983 ） , the prevalence of clinical hypothyroidism was 2. 27% （ n = 45 ） , subclinical hypothyroidism 11.60% （ n = 230 ）, clinical hyperthyroidism 0. 20% （ n = 4 ） , subclinical hyperthyroidism 1.06% （ n = 21 ） , hypothyroxinemia 6.45% （ n = 128 ）, and euthyroid with positive TPOAb 10. 74% （ n=213 ） in our study. Pregnant women with positive TPOAb were susceptible to thyroid dysfunction. It was shown that 79.74% of pregnant women with thyroid disorders were diagnosed by universal thyroid screening. Conclusions 33.89% of pregnant women in the second and third trimesters were identified to suffer from thyroid disorders or positive thyroid autoantibody by universal thyroid screening. Increased prevalence of thyroid dysfunction was found in pregnant women with positive TPOAb. 79.74% of pregnant women with thyroid disorders might be missed if screening was made only in the high risk cases.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2011年第10期816-820,共5页
Chinese Journal of Endocrinology and Metabolism
基金
上海市卫生局科研基金项目（基金编号054017）
