标题：甲状腺过氧化物酶抗体对孕妇甲状腺功能和不良妊娠结局的影响

      作者：刘艳丽，初晓丽，郭海香    (广州医科大学附属深圳沙井医院产科，广东 深圳 518104)

      卷次： 2018年29卷12期

      【摘要】 目的 探讨孕妇甲状腺过氧化物酶抗体(TPOAb)对其甲状腺功能和妊娠结局的影响。方法 选取 2016年 2月至 2017年 2月在广州医科大学附属深圳沙井医院产科建档产检的孕妇作为研究对象，将甲状腺功能正常且TPOAb阳性的 128例孕妇作为观察组，选取同期甲状腺功能正常且TPOAb阴性的 128例孕妇作为对照组，每 4周检测促甲状腺激素(TSH)、游离甲状腺素(FT4)，并比较两组孕妇甲状腺疾病发生率和不良妊娠结局情况。结果 256例孕妇中有17.2% (44/256)发生妊娠不良结局，其中自然流产和妊娠期高血压位居前两位。观察组孕妇的甲状腺功能异常发生率为18.0%，明显高于对照组的7.8%，差异有统计学意义(P<0.05)；观察组孕妇的不良妊娠结局发生率为28.1%，明显高于对照组的6.3%，差异有统计学意义(P<0.05)。结论 孕早期单纯性TPOAb阳性的孕妇易发生甲状腺功能异常，自然流产和妊娠期高血压疾病的不良妊娠结局发生率较高。因此，对于单纯性TPOAb阳性的孕妇，应积极给予随访并行干预性治疗。
      【关键词】 孕妇；甲状腺过氧化物酶抗体；甲状腺功能异常；妊娠结局
      【中图分类号】 R714.14+7 【文献标识码】 A 【文章编号】 1003—6350（2018）12—1672—03

Effects of thyroid peroxidase antibody on thyroid function and adverse pregnancy outcomes in pregnant women.LIU Yan-li, CHU Xiao-li, GUO Hai-xiang.
Department of Obstetrics and Gynecology, the Affliated Shajing Hospital ofGuangzhou Medical University, Shenzhen 518104, Guangdong, CHINA
【Abstract】 Objective To discuss the effect of thyroid peroxidase antibody (TPOAb) on thyroid function andadverse pregnancy outcomes in pregnant women. Methods From February 2016 to February 2017, pregnant women inthe Affliated Shajing Hospital of Guangzhou Medical University were selected as the research objects. A total of 128 cas-es with normal thyroid function and positive TPOAb were divided into the observation group, and 128 cases with normalthyroid function and negative TPOAb were divided into the control group at the same time. Thyroid stimulating hormone(TSH), free thyroxine (FT4) were detected every 4 weeks. Then the incidence rate of maternal thyroid disease and ad-verse pregnancy outcomes were contrasted between the two groups. Results In the 256 pregnant women, 17.2% (44/256) had adverse pregnancy outcomes, mainly spontaneous abortion and pregnancy induced hypertension. The incidenceof abnormal thyroid function in the observation group was 18.0%, which was significantly higher than 7.8% in the con-trol group (P<0.05). The incidence of adverse pregnancy outcome in the observation group was 28.1%, which was signif-icantly higher than 6.3% in the control group (P<0.05). Conclusion Pregnant women with simple TPOAb positive inearly pregnancy are prone to thyroid dysfunction, which leads to an increase in the incidence of adverse pregnancy out-comes of spontaneous abortion and pregnancy induced hypertension. Therefore, simple TPOAb positive pregnant wom-en should be actively followed up and given intervention treatment.
      【Key words】 Pregnant women; Thyroid peroxidase antibody; Abnormal thyroid function; Pregnancy outcome·论 著·doi:10.3969/j.issn.1003-6350.2018.12.014