摘要
目的 探讨反复妊娠丢失(RPL)患者甲状腺自身抗体与机体凝血功能的关系。方法 回顾性收集2019年9月-2021年5月在兰州大学第二医院生殖医学科就诊的RPL患者405例。根据抗甲状腺球蛋白抗体(anti-TGAb)和甲状腺过氧化物酶抗体(TPO-Ab)阳性情况将RPL患者分为:对照组(甲状腺自身抗体阴性组)和甲状腺自身抗体阳性组,甲状腺自身抗体阳性组进一步分为anti-TGAb组、TPO-Ab组和anti-TGAb+TPO-Ab组3个亚组。比较对照组与甲状腺自身抗体阳性组及其各亚组患者的凝血功能、血栓弹力图及血小板计数等指标。结果 甲状腺自身抗体阳性组的凝血酶时间、纤维蛋白降解产物、凝血反应时间及血凝块形成时间明显低于对照组,差异具有统计学意义(P<0.05),其他指标差异无统计学意义(P>0.05)。亚组分析中,各项凝血指标各组间对比差异均无统计学意义(P>0.05)。结论 甲状腺自身抗体阳性的RPL患者与抗体阴性者的凝血功能有所不同,提示RPL患者的甲状腺自身抗体可能对凝血功能存在影响,可在临床上提早筛查及干预以改善妊娠结局。
Objective To investigate the correlation between thyroid autoantibodies and coagulation function in patients with recurrent pregnant loss(RPL).Methods A retrospective study was carried out on 405 patients with RPL in the Department of Reproductive Medicine of Lanzhou University Second Hospital from September 2019 to May 2021.The patients were divided into a control group(thyroid autoantibodies negative group)and thyroid autoantibodies positive group according to whether anti-thyroglobulin antibody(anti-TGAb)and thyroid peroxidase antibody(TPO-Ab)were positive or not.The thyroid autoantibody positive group was further divided into three subgroups:anti-TGAb group,TPO-Ab group and anti-TGAb+TPO-Ab group.The routine blood coagulation test,thromboelastogram and platelet count were compared between the control group and the thyroid autoantibodies positive group and its subgroups.Results The values of thrombin time,fibrin degradation product,clotting time and blood clot formation in the thyroid autoantibodies positive group were significantly lower than those in the control group(P<0.05).There was no significant difference in the comparison of other indicators between the two groups (P > 0.05). In the subgroup analysis, no significant statisticaldifference was found in the coagulation indexes among all groups (P>0.05). Conclusions The coagulationfunction of RPL patients with positive thyroid autoantibodies was different from that of negative autoantibodies,suggesting that thyroid autoantibodies of RPL patients might have an effect on coagulation function,which could be used in clinical screening and intervention in advance to improve pregnancy outcome.
作者
魏志玲
杨凤娜
汪娟
王晨
王芳
Wei Zhiling;Yang Fengna;Wang Juan;Wang Chen;Wang Fang(The Second Clinical Medical School,Lanzhou University,Lanzhou 730030,China;College of Integrated Chinese and Western Medicine,Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Reproductive Medicine,The Second Hospital of Lanzhou University,Lanzhou 730030,China)
出处
《兰州大学学报（医学版）》
2023年第3期18-22,共5页
Journal of Lanzhou University（Medical Sciences）
基金
兰州大学第二医院2019年博士研究生培养专项基金资助项目(YJS-BD-17)。
