本文選題：妊娠 + 甲狀腺過氧化物酶抗體�。� 參考：《中國全科醫(yī)學》2017年36期

【摘要】：目的探討產婦不同甲狀腺過氧化物酶抗體(TPOAb)水平對新生兒甲狀腺功能的影響。方法 2015年1月—2016年6月,選取保定市第一中心醫(yī)院收治的符合納入標準的單純TPOAb陽性產婦33例作為TPOAb陽性組,另選取同期于本院分娩的30例健康產婦作為TPOAb陰性組。所有產婦隨訪至產后6個月。將新生兒根據其母親孕晚期TPOAb水平分為N組(母親為TPOAb陰性組)、A組(母親為TPOAb陽性組),再將A組新生兒依據其母親孕晚期TPOAb水平分為A1亞組(母親孕晚期TPOAb為30~100 U/ml,n=21)和A2亞組(母親孕晚期TPOAb100 U/ml,n=12)。比較N組、A組新生兒出生情況評估資料,N組、A1亞組、A2亞組新生兒出生3~5 d和A1、A2亞組新生兒出生1、3個月甲狀腺功能指標[促甲狀腺激素(TSH)、游離甲狀腺素(FT_4)水平]、甲狀腺抗體指標[TPOAb、甲狀腺球蛋白抗體(TGAb)、甲狀腺球蛋白(TG)水平],并分析TPOAb陽性產婦后代出生3~5 d TSH、FT_4水平與產婦年齡、TPOAb水平的相關性。結果 N組和A組新生兒出生1 min Apgar評分、身長、體質量比較,差異無統(tǒng)計學意義(P0.05)。A1、A2亞組新生兒出生3~5 d TSH、TPOAb、TGAb、TG水平均高于N組,FT_4水平低于N組(P0.05);A2亞組新生兒出生3~5 d TSH、TPOAb、TGAb、TG水平均高于A1亞組,FT_4水平低于A1亞組(P0.05)。A1亞組新生兒出生1個月失訪4例。A1、A2亞組新生兒出生1個月FT_4水平比較,差異無統(tǒng)計學意義(P0.05);A2亞組新生兒出生1個月TSH、TPOAb、TGAb、TG水平高于A1亞組(P0.05)。A1亞組新生兒出生3個月失訪2例。A1、A2亞組新生兒出生3個月FT_4、TPOAb、TG水平比較,差異無統(tǒng)計學意義(P0.05)。A2亞組新生兒出生1個月TSH、TGAb水平高于A1亞組(P0.05)。Pearson相關分析結果顯示,出生3~5 d時新生兒TSH、FT_4與其母親TPOAb水平呈正相關(r值分別為0.393、0.423,P值均0.05)。結論產婦單純TPOAb陽性對新生兒甲狀腺功能有影響,且產婦TPOAb高水平對新生兒甲狀腺功能的影響時間更長。
[Abstract]:Objective to investigate the effect of different levels of thyroid peroxidase antibody (TPOAb) on the thyroid function of newborns. Methods from January 2015 to June 2016, 33 pregnant women with TPOAb positive were selected as TPOAb positive group, and 30 healthy women in the same period were selected as TPOAb negative group. All women were followed up until 6 months postpartum. The newborns were divided into N group (mother TPOAb negative group) (mother was TPOAb positive group) and A group was divided into A1 subgroup according to their mother's late pregnancy TPOAb level. Subgroup A _ 2 (maternal TPOAb100 U / ml) and A _ 2 subgroup (TPOAb100 U / ml) and A _ 2 subgroup. Comparison of neonatal birth assessment data of group N and group A (A 1 subgroup A 2) thyroid function index [thyrotropin TSHT, free thyroxine FT 4], A 2 subgroup and 1 month and 3 months old neonates in group A and A 1 / A subgroup respectively were compared respectively, and 1 month after birth, 1 month after birth. The level of TPOAb (TPOAb, TGAb, TGG) was analyzed, and the correlation between TPOAb level and TPOAb level was analyzed on the 3rd and 5th day after birth. Results 1 min Apgar score, body length and body weight of newborns in group N and group A were compared. There was no significant difference in TG levels of TSHTPOAbAbA1A 2 subgroup and TSHTPOAbAb5 TGAb4 group. All the levels of TG were higher than those of group N and group N were lower than those of group N and group P 0.05 A 2 respectively. TG levels of TSHTPOAbAbA subgroup were higher than those of subgroup A1 subgroup (P 0.05), respectively. The level of TG was higher than that of subgroup A1 (P 0.05) .A1 subgroup was lower than that of A1 subgroup (P 0.05). A1 subgroup was lower than that of A1 subgroup (P 0.05). A1 subgroup was lower than A1 subgroup (P 0.05). Comparison of FTS4 levels in 4 newborns in the A1AA2 subgroup at 1 month after birth. There was no significant difference in TG level of TSHO TPOAbn TGAbAb1 group 1 month old compared with that of A1 subgroup P0.05O.A1 subgroup. 2 newborns with 3 month loss of birth in A1 A1A2 subgroup were compared with 2 cases with 3 months FTS T POAbAb TG level in A1A1A2 subgroup were compared with that in A1 subgroup, and there was no statistical difference in TG level between the two newborns at the first month after birth. There was no significant difference in the level of TSHTGAb in newborns at one month after birth in group P0.05. A2. The results of Pearson correlation analysis showed that there was a positive correlation between TSH-FT4 and TPOAb in newborns at 3d after birth. The values of TSHTGAb were both 0.3930.423P and 0.05P, respectively. Conclusion simple TPOAb positive in puerpera has influence on neonatal thyroid function, and the high level of TPOAb in parturient has longer influence on neonatal thyroid function.
【作者單位】： 河北省保定市第一中心醫(yī)院內分泌二科;
【分類號】：R722.1

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