刘利红++何昆

[摘要]目的 觀察TPOAb阳性及阴性妊娠妇女的甲状腺功能的变化，为孕期妇女的检查、优生优育提供科学依据。方法 收集2015年6月～2016年10月在我院门诊接受甲状腺功能检查的孕期妇女485例，其中TPOAb阳性妇女121例为TPOAb阳性组，TPOAb阴性妇女364例为TPOAb阴性组，均分为孕早期即T1期（1～12周），孕中期即T2期（13～27周），孕晚期即T3期（28～40周）。TPOAb阳性组妇女T1期32例，T2期40例，T3期49例，TPOAb阴性组妇女T1期132例，T2期128例，T3期104例。采用电化学发光法进行游离甲状腺素（FT4）、促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPO-Ab）的检测，对上述病例的临床资料进行了回顾性分析。结果 TPOAb阳性组妇女的甲状腺疾病发病率明显高于TPOAb阴性组，差异有统计学意义（χ2=93.74，P=0.00）。其中亚临床甲状腺功能减退的患病率随着孕期增长而明显上升，差异有统计学意义（χ2=9.63，P=0.01）。结论 孕期妇女TPOAb的化验有重要意义，能预测孕期亚临床甲状腺功能减退的风险，是孕期化验的必要项目。

[关键词]妊娠；甲状腺过氧化物酶抗体；甲状腺疾病；亚临床甲状腺功能减退

[中图分类号] R587.2 [文献标识码] A [文章编号] 1674-4721（2017）09（b）-0074-03

Changes of thyroid peroxidase antibody and thyroid function during pregnancy

LIU Li-hong HE Kun

Department of Endocrinology，Xingtai Third Hospital，Hebei Province，Xingtai 054000，China

[Abstract]Objective To observe the change of thyroid function in women with TPOAb positive and negative at reproductive age，and to provide a scientific basis for the pre-pregnancy examination and eugenics.Methods 485 women of reproductive age done thyroid function check were continuous collected from our hospital outpatients from June 2015 to October 2016，among which 121 cases of TPOAb positive women were divided into TPOAb positive group and other 364 TPOAb negative women were divided into TPOAb negative group.Each group was divided into early pregnancy T1 period （1-12 weeks），metaphase pregnancy T2 period （13-27 weeks） and late pregnancy T3 period （28-40 weeks）.TPOAb positive group had 32 cases in T1 period，40 cases in T2 period and 49 cases in T3 period.TPOAb negative group had 132 cases in T1 period，128 cases in T2 period and 104 cases in T3 period.Electrochemiluminescence Method was used to detect free thyroxine （FT4），thyroid stimulating hormone （TSH），and thyroid peroxidase antibody （TPO-Ab）.The clinical data of the above cases were retrospectively analyzed.Results The incidence of hypothyroidism in women with TOPAb positive group was significantly higher than that in TOPAb negative group，the difference between the two groups was statistically significant （χ2=93.74，P=0.00）.And the incidence of subclinical hypothyroidism was significantly increased with the increase of gestational age，the difference was statistically significant （χ2=9.63，P=0.01）.Conclusion The test of TPOAb for pregnant women is important and can predict the risk of hypothyroidism.It is necessary for pregnancy test.

[Key words]Pregnancy；Thyroid Peroxidase antibody；Thyroid disease； Subclinical hypothyroidismendprint

近年来，人们对于妊娠合并甲状腺疾病的关注日益增多，甲状腺疾病是仅次于妊娠期糖尿病的第二大妊娠期内分泌疾病[1]。据中华医学会内分泌学会进行的《十城市社区居民的甲状腺疾病流行病学调查》结果显示，甲减的患病率为6.5%，而妊娠期妇女甲状腺疾病的发生率高于非妊娠期妇女[2]。随着妊娠期甲状腺功能筛查的普及，我国甲状腺功能减退症（简称“甲减”）的患病率逐年增长[3]。本文通过分析妊娠期间TPOAb阳性与阴性妇女甲状腺功能的变化，阐明了在妊娠期化验TPOAb的必要性，提出了TPOAb阳性能预测甲减的风险，为优生优育提供科学依据。……