摘要
目的探讨妊娠8～12周甲状腺过氧化物酶抗体(TPOAb)阳性对甲状腺功能的影响。方法对2010年9月至2011年6月北京友谊医院产科门诊行产前检查的611例无甲状腺疾病高危因素的健康初产妇,于妊娠8～12周进行甲状腺功能[促甲状腺激素(TSH)、游离四碘甲状腺原氨酸(FT4)]和TPOAb的检测,通过制定早孕期甲状腺功能正常参考区间,分析TPOAb阳性切割值、阳性率及对TSH、FT4的影响。结果 (1)妊娠8～12周TPOAb中位数值及变化范围为38.9(6.4～>1300)mU/L。(2)通过建立妊娠8～12周人群特异参考标准,以第90百分位计算TPOAb阳性切割值为206.77mU/L,TPOAb阳性率为10.8%(66/611)。(3)回归分析显示:TPO-Ab滴度与TSH呈正相关,与FT4呈负相关,P值均为0.000。妊娠8～12周TPOAb阳性妇女TSH中位数值较TPOAb阴性者升高0.4mU/L,前者TSH异常升高的风险是后者的4.4倍。结论妊娠8～12周TPOAb阳性率为10.8%,通过建立妊娠期人群特异甲状腺功能参考标准和TPOAb阳性切割值,可避免过高估计TPOAb的阳性率。TPOAb阳性孕妇发生TSH异常升高的风险明显增加。
Objective To assess the prevalence of thyroid peroxidase autoantibody and relationships between thyroid function and TPOAb in the first trimester of pregnancy. Methods A total of 611 women during the first trimester from Beijing Friendship Hospital are tested for serum TSH, FT4 and anti-TPO by chemilumino metric immunoanalysis . Women with previous thyroid diseases are excluded. We determine the reference intervals for TSH and ETa and establish the prev- alence of TPOAb by using gestational age -specific interval. The relationships between TSH, FT4 and TPOAb are analyzed. Results （ 1 ）The median value of TPOAb is 38.9 mU/L,ranging from 6. 4 to more thanl 300 mU/L at 8-12 gestational week . （2） The cutoff value of TPOAb is 206. 77 mU/L at the 90th percentile by using gestational age-specific interval. The positive rate of TPOAb is 10. 8% （66/611 ）. （ 3 ） A simple regression analysis shows that serum titer of TPOAb correlates with the levels of TSH and FT4 （P = 0. 000 and 0. 000） . The median concentration of TSH is significantly gTeater in TPOAb-positive women than in TPOAb-negative women with increased value of 0. 40 mU/L. The risk of abnormally high TSH in former is more than three times than in latter. Conclusion TPOAb positive rate is 10. 8% in first trimester. Determination of the gestational age-specific intervals for TSH, FT4 and TPOAb is of very importance to avoid overestimation of maternal thyroid dysfunction. Pregnant women with TPOAb-positive have a higher level of TSH and should be monitored closely for thyroid function.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2012年第12期924-927,共4页
Chinese Journal of Practical Gynecology and Obstetrics
基金
北京市科委科研课题(D101100050010033)
关键词
早孕期
甲状腺过氧化物酶抗体
孕周特异甲状腺功能参考区间
first trimester
thyroid peroxidase autoantibody
gestational age-specific intervals for thyroid function
