摘要
目的 探究甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、促甲状腺激素受体抗体(thyroid stimulating hormone receptor antibody,TRAb)、促甲状腺激素(thyroidstimulating hormone,TSH)在妊娠合并亚临床甲减(subclinical hypothyroidism,SCH)患者中的表达及临床意义。方法 选取2020年1月—2021年10月200例南京市江宁医院收治的妊娠合并亚临床甲状腺功能减退患者为研究对象,并选取同期妊娠期甲状腺功能正常的170例为对照组。采用全自动化学发光仪测定TPOAb、TRAb、TSH、血清游离甲状腺素(free thyroxine,FT_(4))、血清游离三碘甲腺原氨酸(free triiodothyronine,FT_(3))水平,对比各组患者血清中TPOAb、TRAb、TSH水平,分析TPOAb、TRAb、TSH在妊娠合并SCH中的表达及意义。结果 与对照组相比,研究组患者血清中TPOAb、TRAb、TSH水平较高,差异有统计学意义(P <0.05)。与对照组相比,研究组患者血清中FT_(4)、FT_(3)水平较低,差异有统计学意义(P <0.05)。与早期妊娠患者相比,中期、晚期妊娠患者TSH水平降低,TPOAb、TRAb水平升高,差异有统计学意义(P <0.05);与中期妊娠患者相比,晚期妊娠患者TSH水平降低,TPOAb、TRAb水平升高,差异有统计学意义(P <0.05)。Logistic回归分析血清TPOAb、TRAb、TSH水平升高与妊娠合并SCH独立相关(P <0.05)。受试者工作特征曲线(receiver operating characteristic,ROC)分析TPOAb、TRAb、TSH预测妊娠合并SCH曲线下面积(area under curve,AUC)分别为0.865、0.855,0.723。结论 妊娠合并SCH患者血清TPOAb、TRAb、TSH水平显著升高,高水平TPOAb、TRAb、TSH是妊娠合并SCH的风险预测因子。
Objective To explore the effects of thyroid peroxidase antibody(TPOAb),thyroid stimulating hormone receptor antibody(TRAb)and thyroid-stimulating hormone(TSH)in expression and clinical significance in patients with pregnancy complicated with subclinical hypothyroidism(SCH).Methods A total of 200 cases of pregnant patients with subclinical hypothyroidism admitted to Nanjing Jiangning Hospital from January 2020 to October 2021 were selected as the research object,and 170 cases of normal thyroid function during pregnancy in the same period were selected as the control group.The levels of TPOAb,TRAb,TSH,free thyroxine(FT_(4))and free triiodothyronine(FT_(3))were determined by the fully automatic chemiluminescence,compared the serum levels of TPOAb,TRAb and TSH in each group,and the expression and significance of TPOAb,TRAb and TSH in pregnancy with SCH were analyzed.Results Compared with the control group,the serum levels of TPOAb,TRAb and TSH in the study group were higher,the difference was statistically significant(P<0.05).Compared with the control group,the serum levels of FT_(4) and FT_(3) in the study group were lower,the difference was statistically significant(P<0.05).Compared with patients with early pregnancy,patients with middle and late pregnancy had lower TSH levels and higher TPOAb and TRAb levels,the difference was statistically significant(P<0.05).Compared with the patients of second trimester pregnancy,the levels of TSH decreased and the levels of TPOAb and TRAb increased in patients of third trimester pregnancy,the difference was statistically significant(P<0.05).Logistic regression analysis showed that the elevated levels of serum TPOAb,TRAb and TSH were independently correlated with pregnancy complicated with SCH(P<0.05).Receiver operating characteristic(ROC)analysis of TPOAb,TRAb,TSH predicted pregnancy combined with SCH area under curve(AUC)were 0.865,0.855,0.723,respectively.Conclusion The serum levels of TPOAb,TRAb and TSH in pregnancy with SCH were significantly increased,and high levels of TPOAb,TRAb and TSH were risk predictors of pregnancy with SCH.
作者
沈敦隽
黄晓林
SHEN Dunjuan;HUANG Xiaolin(Department of Obstetrics and Gynecology,Nanjing Jiangning Hospital,Nanjing Jiangsu 211100,China)
出处
《中国卫生标准管理》
2022年第15期72-76,共5页
China Health Standard Management
