本文關(guān)鍵詞：不同TSH標(biāo)準(zhǔn)診斷的妊娠早期亞甲減及TPO-Ab陽(yáng)性對(duì)妊娠的影響分析　出處：《現(xiàn)代醫(yī)學(xué)》2016年12期 　論文類型：期刊論文

  更多相關(guān)文章： 妊娠合并癥 亞臨床型甲狀腺功能減退 促甲狀腺激素 甲狀腺過(guò)氧化物酶抗體 妊娠結(jié)局

【摘要】：目的:探討不同促甲狀腺激素(TSH)標(biāo)準(zhǔn)診斷的妊娠早期亞臨床型甲狀腺功能減退(亞甲減)及甲狀腺過(guò)氧化物酶抗體(TPO-Ab)陽(yáng)性對(duì)妊娠的影響。方法:選取我院產(chǎn)科孕早期開(kāi)始行產(chǎn)前檢查至結(jié)束妊娠的孕婦1 025例,在不同的TSH診斷標(biāo)準(zhǔn)(A標(biāo)準(zhǔn)TSH2.5 mU·L~(-1)、B標(biāo)準(zhǔn)TSH5.76 mU·L~(-1))下不同TPO-Ab檢測(cè)結(jié)果患者的亞甲減發(fā)生率、妊娠并發(fā)癥和妊娠不良結(jié)局發(fā)生率以及胎兒不良結(jié)局發(fā)生率的差異。結(jié)果:研究對(duì)象TPO-Ab陽(yáng)性率為12.29%;按A標(biāo)準(zhǔn),TPO-Ab陽(yáng)性者亞甲減發(fā)生率高于TPO-Ab陰性者(P0.05);按B標(biāo)準(zhǔn),TPO-Ab陽(yáng)性者亞甲減發(fā)生率也高于TPO-Ab陰性者(P0.05)。妊娠并發(fā)癥和妊娠不良結(jié)局發(fā)生率按A標(biāo)準(zhǔn)者低于按B標(biāo)準(zhǔn)者(P0.05),且按B標(biāo)準(zhǔn)TPO-Ab陽(yáng)性者高于TPO-Ab陰性者(P0.05)。胎兒不良結(jié)局發(fā)生率按A標(biāo)準(zhǔn)者低于按B標(biāo)準(zhǔn)者(P0.05),且按A標(biāo)準(zhǔn)TPO-Ab陽(yáng)性者高于TPO-Ab陰性者,按B標(biāo)準(zhǔn)TPO-Ab陽(yáng)性者也高于TPO-Ab陰性者,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:TSH和TPO-Ab是預(yù)測(cè)甲狀腺功能異常和妊娠不良結(jié)局的重要臨床指標(biāo),目前國(guó)際慣用TSH2.5 mU·L~(-1)為亞甲減的診斷標(biāo)準(zhǔn),其更利于預(yù)測(cè)甲狀腺功能異常和妊娠不良結(jié)局的發(fā)生。
[Abstract]:Objective: to investigate subclinical hypothyroidism (hypothyroidism) and thyroid peroxidase antibody (TPO-Abb) in early pregnancy diagnosed by different TSH criteria. Methods: 1 025 pregnant women in our hospital from the beginning of antenatal examination to the end of pregnancy were selected. In different TSH diagnostic criteria, A standard TSH2.5 mu 路LU -1). The incidence of hypothyroidism in patients with different TPO-Ab results under B standard TSH5.76 mu 路L ~ (-1). Results: the positive rate of TPO-Ab was 12.29%. The incidence of hypothyroidism in TPO-Ab positive group was higher than that in TPO-Ab negative group (P 0.05). B standard. The incidence of hypothyroidism in TPO-Ab positive patients was also higher than that in TPO-Ab negative patients (P 0.05). The incidence of fetal adverse outcome in patients with TPO-Ab positive according to B standard was higher than that in those with negative TPO-Ab, and the incidence of fetal adverse outcome was lower than that in patients with B standard (P 0.05). TPO-Ab positive according to A standard was higher than TPO-Ab negative, and TPO-Ab positive according to B standard was higher than TPO-Ab negative. Conclusion TSH and TPO-Ab are important clinical indexes for predicting abnormal thyroid function and adverse outcome of pregnancy. At present, TSH2.5 mu 路L ~ (-1) is used as the diagnostic standard of hypothyroidism, which is more helpful to predict the abnormal thyroid function and the adverse outcome of pregnancy.
【作者單位】： 南京醫(yī)科大學(xué)附屬淮安第一醫(yī)院產(chǎn)科;
【分類號(hào)】：R714.256
【正文快照】： 妊娠期孕婦甲狀腺體積增大,血流較之前豐富,甲狀腺激素水平上升,同時(shí)體內(nèi)人絨毛膜促性腺激素、促甲狀腺激素(thyroidstimulating hormone,TSH)等出現(xiàn)規(guī)律化變動(dòng)[1]。甲狀腺功能障礙易引發(fā)貧血、高血壓等并發(fā)癥,造成不良妊娠結(jié)局,是妊娠期常見(jiàn)內(nèi)分泌疾病[2]。妊娠期TSH水平、甲

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