本文選題：甲狀腺過氧化物酶抗體 + 妊娠��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:本研究通過分析母血及臍帶血TPOAb水平、TPOAb IgG各亞類胎盤通過能力及TPOAb與Th1,Th17細(xì)胞亞群相關(guān)因子TNF-α、IFN-γ、IL-17、IL-22的關(guān)系,探討TPOAb可能的作用機(jī)制,為今后更進(jìn)一步了解TPOAb的生物學(xué)行為提供基礎(chǔ)依據(jù)。方法:隨機(jī)選取2015.8-2016.3期間在我院產(chǎn)科進(jìn)行常規(guī)產(chǎn)前檢查和分娩的12例TPOAb陽性(觀察組)及22例TPOAb陰性且無甲狀腺疾病病史(對照組)妊娠婦女作為研究對象。測定觀察組及對照組妊娠婦女分娩前靜脈血(母血)及分娩后新生兒臍帶靜脈血(臍帶血)的TPOAb、TSH、FT4、FT3水平、TPOAb IgG各亞類及TNF-α、IFN-γ、IL-17、IL-22水平。(1)分別比較觀察組與對照組中母血及臍帶血中TPOAb、TSH、FT4、FT3水平、TPOAb IgG各亞類及TNF-α、IFN-γ、IL-17、IL-22水平的差異性;(2)比較觀察組中母血與臍帶血TPOAb、TSH、FT4、FT3水平及TNF-α、IFN-γ、IL-17、IL-22的差異性,計(jì)算TPOAb IgG各亞類胎盤通過率;(3)進(jìn)一步分析觀察組母血及臍帶血中TPOAb水平與TNF-α、IFN-γ、IL-17、IL-22的相關(guān)性。結(jié)果:(1)與對照組母血間比較:(1)觀察組母血TPOAb水平明顯升高(P=0.000),(2)觀察組母血TPOAb IgG總、IgG1均升高(分別P為0.012、0.016),(3)觀察組母血TNF-α、IFN-γ、IL-17、IL-22水平均明顯升高(分別P為0.039、0.031、0.010、0.000),(4)兩組間其余各指標(biāo)比較,均無顯著性差異(均P0.05);(2)與對照組臍帶血比較:(1)觀察組臍帶血TSH、TPOAb水平升高(分別P為0.044、0.000),FT3水平降低(P=0.033),(2)觀察組臍帶血TPOAb IgG總、IgG1均明顯升高(分別P為0.002、0.025),(3)觀察組臍帶血TNF-α、IFN-γ、IL-17、IL-22水平也均顯著升高(分別P為0.008、0.024、0.027、0.016),(4)兩組間其余各指標(biāo)比較,均無顯著性差異(均P0.05);(3)觀察組臍血與母血間比較:(1)臍帶血TSH、FT4水平高于母血中水平(分別P為0.006、0.000),(2)臍帶血FT3水平低于母血中水平(P=0.000),(3)臍帶血與母血間TPOAb水平無顯著差異(P0.05),(4)觀察組IgG各亞類胎盤通過狀態(tài)呈IgG1=IgG3IgG2=IgG4,即IgG1胎盤通過率高于IgG2及IgG4(分別P為0.004、0.028),IgG3胎盤通過率高于IgG2及IgG4(分別P為0.003、0.019);(4)對照組臍血與母血間比較:(1)臍帶血TSH、FT4水平高于母血中水平(分別P為0.000、0.000),(2)臍帶血FT3、TPOAb水平低于母血中水平(分別P為0.000、0.000),(3)對照組IgG各亞類胎盤通過狀態(tài)為IgG1=IgG4IgG2=IgG3,即IgG1胎盤通過率高于IgG2及IgG3(P值分別為0.000、0.000),IgG4胎盤通過率高于IgG2及IgG3(P值分別為0.027、0.006);(5)觀察組各指標(biāo)間相關(guān)性分析:(1)母血TPOAb與臍帶血TPOAb水平呈正相關(guān)(r=0.636,P=0.000),母血中TPOAb水平與母血中TNF-α、IFN-γ、IL-17、IL-22均成正相關(guān)(分別r為0.686、0.689、0.661、0.591;分別P為0.014、0.013、0.019、0.043);(2)臍帶血TPOAb水平與臍帶血TSH水平成正相關(guān)(r=0.930,P=0.000),臍帶血TPOAb水平與臍帶血TNF-α、IFN-γ、IL-17、IL-22均不相關(guān)(均P0.05);(3)母血與臍帶血中TNF-α、IFN-γ、IL-17、IL-22水平均不相關(guān)(均P0.05)。結(jié)論:1.母體TPOAb陽性可能會(huì)對新生兒甲狀腺功能產(chǎn)生影響;2.母體TPOAb陽性分娩前母血及臍帶血以TPOAb IgG1亞類升高為主;3.母體TPOAb陽性妊娠末期以TPOAb IgG1、IgG3亞類胎盤通過率最高;4.母體TPOAb陽性可能通過Th1,Th17細(xì)胞亞群相關(guān)因子TNF-α、IFN-γ、IL-17、IL-22等介導(dǎo)母兒免疫損傷。
[Abstract]:Objective: by analyzing the TPOAb level of maternal blood and umbilical cord blood, the passing ability of TPOAb IgG subclass placenta and the relationship between TPOAb and Th1, Th17 cell subgroup related factors TNF- a, IFN- gamma, IL-17 and IL-22, the mechanism of TPOAb possible action is explored to provide the basis for further understanding of the biological behavior of TPOAb. Method: 2015.8 During the period of -2016.3, 12 cases of TPOAb positive (observation group) and 22 cases of TPOAb negative and no history of thyroid disease (control group) were used in the obstetrics and Gynecology of our hospital as the study subjects. The TPOAb of the observation group and the control group of pregnant women before delivery (mother blood) and the umbilical cord blood (cord blood) of the newborn infants after delivery TSH, FT4, FT3 levels, TPOAb IgG subclasses and TNF- alpha, IFN- gamma, IL-17, IL-22 levels. (1) the differences in the level of TPOAb, TSH, FT4, and umbilical blood in the maternal and umbilical cord blood of the observation group and the control group were compared respectively; (2) the level of maternal blood and umbilical cord blood in the observation group was compared. The difference between IL-17 and IL-22 was used to calculate the placental passing rate of each subclass of TPOAb IgG; (3) the correlation between the level of TPOAb in the maternal and umbilical cord blood of the observation group was further analyzed with TNF- alpha, IFN- gamma, IL-17 and IL-22. (1) (1) the level of mother blood TPOAb increased significantly (P=0.000) in the observation group (2) the mother blood of the observation group increased (1). P was 0.012,0.016), and (3) the level of TNF- a, IFN- gamma, IL-17 and IL-22 in the mother blood of the observation group increased significantly (P 0.039,0.031,0.010,0.000 respectively), and (4) the remaining indexes of the two groups were not significantly different (all P0.05); (2) the umbilical cord blood of the control group was compared with that of the control group: (1) the umbilical cord blood TSH, TPOAb level increased (respectively). Low (P=0.033), (2) the total TPOAb IgG of umbilical cord blood in the observation group increased significantly (P 0.002,0.025), and (3) the level of umbilical cord blood TNF- a, IFN- gamma, IL-17 and IL-22 increased significantly (P 0.008,0.024,0.027,0.016), and (4) there was no significant difference between the two groups, and (3) the comparison between the umbilical cord blood and the mother blood in the observation group: (3): (3) the comparison between the umbilical cord blood and the mother blood in the observation group: (1) the level of TSH and FT4 in umbilical cord blood was higher than that in the mother blood (P 0.006,0.000 respectively), and (2) the level of FT3 in umbilical cord blood was lower than that of the mother blood (P=0.000). (3) there was no significant difference in the TPOAb level between the umbilical cord blood and the mother blood (P0.05), (4) the passing state of the placenta in the IgG subgroups of the observation group was IgG1=IgG3IgG2=IgG4, that is, the rate of IgG1 placenta was higher than that of IgG2 and 0.004. (0.004 0.028), the passing rate of IgG3 placenta was higher than that of IgG2 and IgG4 (P 0.003,0.019 respectively), and (4) comparison between the umbilical cord blood and the mother blood in the control group: (1) the umbilical cord blood was TSH, the level of FT4 was higher than the level of the mother blood (P is 0.000,0.000), (2) the umbilical cord blood FT3, TPOAb level was lower than that of the mother blood (respectively), and (3) the placenta passing state of the control group was (3) The passing rate of G4IgG2=IgG3, IgG1 placenta was higher than that of IgG2 and IgG3 (P value was 0.000,0.000), and the passing rate of IgG4 placenta was higher than IgG2 and IgG3 (P value was 0.027,0.006). (5) correlation analysis between the indexes of the observation group: (1) there was a positive correlation between the maternal blood TPOAb and the level of umbilical cord blood. IL-22 was positively correlated (r was 0.686,0.689,0.661,0.591, P was 0.014,0.013,0.019,0.043 respectively); (2) the level of umbilical cord blood TPOAb was positively correlated with the level of umbilical cord blood TSH (r=0.930, P=0.000). The level of TPOAb in umbilical cord blood was not related to TNF- alpha, IFN- gamma, and umbilical cord blood. Mean unrelated (mean P0.05). Conclusion: 1. maternal TPOAb positive may affect the thyroid function of newborns; 2. maternal TPOAb positive maternal and umbilical cord blood before delivery of TPOAb IgG1 subclass; 3. maternal TPOAb positive pregnancy at the end of TPOAb IgG1, the IgG3 subclass placental pass rate is the highest; 4. mother TPOAb positive may pass Th1, Th17 thin Cell subgroup related factors TNF- alpha, IFN- gamma, IL-17 and IL-22 mediate maternal and fetal immune injury.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R714.256

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相關(guān)期刊論文 前10條

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本文編號：1915574