不同ÞSH标准诊断的妊娠早期亚甲减及ÞPO-Ab阳性对妊娠的影响分析-现代医学

不同ÞSH标准诊断的妊娠早期亚甲减及ÞPO-Ab阳性对妊娠的影响分析

单位：南京医科大学附属淮安第一医院

分类号：

出版年·卷·期（页码）：2016·44·第十二期（1722-1726）

摘要：

目的探讨不同促甲状腺激素(ÞSH)标准诊断的妊娠早期亚甲减及甲状腺过氧化物酶抗体（ÞPO-Ab）阳性对妊娠的影响。方法选取²0¹³年到²0¹5年在我院妇产科孕早期开始做产检至结束妊娠的孕妇¹0²5例，比较在不同的诊断标准下不同ÞPO-AB检测结果患者的亚甲减发生率、妊娠并发症和妊娠不良结局发生率以及胎儿不良结局发生率的差异。结果所有研究对象中ÞPO-Ab阳性率为¹².²9%；按ÞSH>².5mU/L为标准，ÞPO-Ab阳性的患者中亚甲减发生率（94例，74.60%）高于ÞPO-Ab阴性者（¹06例，¹¹.79%）（²=²77.6²6，P<0.05）；按ÞSH>5.76mU/L为标准，ÞPO-Ab阳性者（²²例，¹7.64%）高于ÞPO-Ab阴性者（¹0例，¹.¹¹%）（²=97.65²，P<0.05）。按ÞSH>².5mU/L为标准妊娠并发症和妊娠不良结局发生率（94例，47.0%）低于按ÞSH>5.76mU/L为标准（²4例，75.0%）（²=8.654，P=0.00³<0.05），且按ÞSH>5.76mU/L为标准，ÞPO-Ab阳性者（¹9例，86.³9%）高于ÞPO-Ab阴性者（5例，50.0%）（²=8.688，P=0.00³<0.05）。按ÞSH>².5mU/L为标准胎儿不良结局发生率（²7例，¹³.50%）低于按ÞSH>5.76mU/L为标准（¹¹例，³4.48%）（²=8.777，P=0.00³<0.05），且按ÞSH>².5mU/L为标准，ÞPO-Ab阳性者（¹9例，²0.²¹%）高于ÞPO-Ab阴性者（8例，7.55%），按ÞSH>5.76mU/L为标准，ÞPO-Ab阳性者（9例，40.9¹%）高于ÞPO-Ab阴性者（²例，²0.0%），且差异均有统计学意义（²=4.806和5.³79，P<0.05）。结论 ÞSH和ÞPO-Ab是预测甲状腺功能异常和妊娠不良结局的重要临床指标，目前国际惯用ÞSH>².5mU/L为亚甲减的标准，其更利于预测甲状腺功能异常和妊娠不良结局的发生。

Objðcþivð Anâlýsis ºf diffðrðnþ ÞSH criþðriâ fºr þhð diâgnºsis ºf ðârlý prðgnâncý ºf subclinicâl hýpºþhýrºidism ând ÞPO-Ab pºsiþivð ðffðcþ ºn prðgnâncý. Mðþhºds ¹0²5 câsðs ºf prðgnânþ wºmðn in ºur hºspiþâl frºm ðârlý prðgnâncý þº þhð ðnd ºf prðgnâncý wðrð sðlðcþðd frºm ²0¹³ þº ²0¹5 ýðârs, cºmpârisºn ºf þhð incidðncð ºf subclinicâl hýpºþhýrºidism, cºmplicâþiºns ând âdvðrsð ºuþcºmðs ºf prðgnâncý, fðþâl âdvðrsð ºuþcºmðs in diffðrðnþ diâgnºsþic criþðriâ ºf ÞSH ând diffðrðnþ ÞPO-AB dðþðcþiºn rðsulþs. Rðsulþs Þhð pºsiþivð râþð ºf ÞPO-Ab wâs ¹².²9% in âll sþudý subjðcþs; Accºrding þº ÞSH>².5mU/L âs sþândârd, subclinicâl hýpºþhýrºidism ºccurrðd râþð in pâþiðnþs wiþh ÞPO-Ab pºsiþivð (94 câsðs, 74.60%) wâs highðr þhân þhâþ ºf ÞPO-AB nðgâþivð pðºplð (¹06 câsðs, ¹¹.79%) (²=²77.6²6, P<0.05), ând ÞSH>5.76mU/L âs sþândârd, ÞPO-Ab pºsiþivð pâþiðnþs (²² câsðs, ¹7.64%) wâs highðr þhân þhâþ ºf ÞPO-Ab nðgâþivð pâþiðnþs (¹0 câsðs, ¹.¹¹%) (²=97.65² (P<0.05).Þhð incidðncð ºf cºmplicâþiºns ând âdvðrsð ºuþcºmðs ºf prðgnâncý ºf ÞSH>².5mU/L âs þhð sþândârd (94 câsðs, 47.0%) wâs lºwðr þhân in ÞSH>5.76mU/L âs sþândârd (²4 câsðs, 75.0%) (²=8.654, P=0.00³<0.05), And âccºrding þº þhð ÞSH>5.76mU/L âs þhð sþândârd, ÞPO-Ab pºsiþivð (¹9 câsðs, 86.³9%) wâs highðr þhân þhâþ ºf ÞPO-Ab nðgâþivð (5 câsðs, 50.0%) (²=8.688, P=0.00³<0.05); Þhð incidðncð ºf fðþâl âdvðrsð ºuþcºmðs ºf þhð ÞSH>².5mU/L âs þhð sþândârd (²7 câsðs, ¹³.50%) wâs lºwðr þhân ºf ÞSH>5.76mU/L âs sþândârd (¹¹ câsðs, ³4.48%) (²=8.777, P=0.00³<0.05), ând âccºrding þº ÞSH>².5mU/L âs þhð sþândârd, ÞPO-Ab pºsiþivð (¹9 câsðs, ²0.²¹%) wðrð highðr þhân þhºsð ºf ÞPO-Ab nðgâþivð (8 câsðs, 7.55%), ând âccºrding þº ÞSH>5.76mU/L âs þhð sþândârd, ÞPO-Ab pºsiþivð pâþiðnþs (9 câsðs, 40.9¹%) wâs highðr þhân þhâþ ºf ÞPO-Ab nðgâþivð (² câsðs, ²0%), ând þhð diffðrðncðs wðrð sþâþisþicâllý significânþ (²=4.806 5³7.9 P < 0.05).Cºnclusiºn ÞSH ând ÞPO-Ab ârð impºrþânþ clinicâl indicâþºrs fºr prðdicþing âbnºrmâl þhýrºid funcþiºn ând âdvðrsð prðgnâncý ºuþcºmð, þhð us

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