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目的:探讨血清甲状腺过氧化物酶抗体(TPOAb)对于患有自身免疫性甲状腺功能紊乱的孕妇的临床诊断价值。方法:筛选2009年9月至2013年1月我院收治的205例孕妇,其中甲状腺功能紊乱孕妇55例(紊乱组),非甲状腺功能紊乱孕妇150例(非紊乱组);非紊乱组中,年龄>30岁的高龄孕妇50例(高龄组),年龄≤30岁的孕妇100例(正常组)。采用化学发光法,测定所有孕妇血清中游离甲状腺三碘原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)和TPOAb水平。结果:紊乱组患者血清中TSH、TPOAb及TPOAb阳性率水平显著高于非紊乱组,且存在统计学意义(均P<0.05),而两组患者血清中FT3和FT4水平无统计学意义(均P>0.05);高龄组和正常组血清中TSH、FT3、FT4及TPOAb水平均无统计学意义(均P>0.05);与TSH正常组相比,TSH异常组中约有超过半数TPOAb表现为阳性,有统计学意义(P<0.05);孕妇体内的TSH水平正常与否,均有出现TPOAb阳性的可能,在TSH水平较高(>4.67 m IU/L)中,TPOAb阳性概率更高。结论:TSH、FT3、FT4水平正常而TPOAb呈阳性的孕妇依然存在自身免疫性甲状腺功能紊乱的可能性,监测TPOAb的水平对于妊娠期孕妇功能紊乱的诊断与治疗具有重要意义。
Objective: To investigate the clinical diagnostic value of serum thyroid peroxidase antibody (TPOAb) in pregnant women with autoimmune thyroid dysfunction. Methods: A total of 205 pregnant women admitted to our hospital from September 2009 to January 2013 were selected, of whom 55 were pregnant with thyroid dysfunction (disorder group) and 150 were non-thyroid disorder (non-disorder group). In non-disorder group, 50 elderly pregnant women aged 30 years (senior group), 100 pregnant women ≤ 30 years old (normal group). Chemiluminescence method was used to detect free thyroid triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH) and TPOAb levels in all pregnant women. Results: The positive rates of serum TSH, TPOAb and TPOAb in patients with disorder were significantly higher than those in non-disorder patients (all P <0.05), while there was no significant difference in serum FT3 and FT4 between the two groups (P> 0.05). There was no significant difference in the levels of serum TSH, FT3, FT4 and TPOAb between the elderly group and the normal group (all P> 0.05). Compared with the normal TSH group, more than half TPOAb in the TSH group Positive and statistically significant (P <0.05). The positive rate of TPOAb was higher in TSH patients with higher TSH level (> 4.67 m IU / L), both of which were normal or not. Conclusion: It is possible that pregnant women with normal TSH, FT3 and FT4 levels and TPOAb positive still have autoimmune thyroid dysfunction. Monitoring the level of TPOAb is of great significance for the diagnosis and treatment of pregnant women with functional disorders.