中国医药
中國醫藥
중국의약
China Medicine
2015年
9期
1361-1364
,共4页
妊娠%甲状腺过氧化物酶抗体%妊娠结局%临床干预
妊娠%甲狀腺過氧化物酶抗體%妊娠結跼%臨床榦預
임신%갑상선과양화물매항체%임신결국%림상간예
Pregnancy%Thyroid peroxidase antibody%Pregnancy outcomes%Clinical intervention
目的 探讨甲状腺过氧化物酶抗体(TPOAb)阳性孕妇妊娠结局及进行临床干预的必要性.方法 选取2012年6月至2014年6月于上海交通大学医学院附属国际和平妇幼保健院就诊并定期随访的单纯TPOAb阳性孕妇122例.根据是否给予左甲状腺素钠片将孕妇分为单纯TPOAb阳性组(87例);左甲状腺素钠片干预组(35例),发现促甲状腺素升高后及时给予左甲状腺素钠片治疗;另外选择同期分娩的健康孕妇85名作为健康对照组.妊娠期定期随访和评价甲状腺功能,比较3组孕妇妊娠期并发症及结局.结果 单纯TPOAb阳性组和左甲状腺素钠片干预组与健康对照组比较,胎膜早破、羊水异常、胎儿窘迫发生率差异有统计学意义[25.3% (22/87)、31.4% (11/35)比10.6% (9/85),16.1% (14/87)、20.0%(7/35)比5.9% (5/85),27.6%(24/87)、34.3%(12/35)比10.6% (9/85),P<O.05],而妊娠期糖尿病、妊娠期高血压、早产发生率及有不良孕产史者占比差异无统计学意义(P>0.05).单纯TPOAb阳性组和左甲状腺素钠片干预组比较,上述各项指标差异均无统计学意义(P>0.05).结论 妊娠期TPOAb阳性与妊娠期胎膜早破、羊水异常及胎儿窘迫相关.给予左甲状腺素钠片干预后,妊娠期不良结局仍与单纯TPOAb阳性者相似.
目的 探討甲狀腺過氧化物酶抗體(TPOAb)暘性孕婦妊娠結跼及進行臨床榦預的必要性.方法 選取2012年6月至2014年6月于上海交通大學醫學院附屬國際和平婦幼保健院就診併定期隨訪的單純TPOAb暘性孕婦122例.根據是否給予左甲狀腺素鈉片將孕婦分為單純TPOAb暘性組(87例);左甲狀腺素鈉片榦預組(35例),髮現促甲狀腺素升高後及時給予左甲狀腺素鈉片治療;另外選擇同期分娩的健康孕婦85名作為健康對照組.妊娠期定期隨訪和評價甲狀腺功能,比較3組孕婦妊娠期併髮癥及結跼.結果 單純TPOAb暘性組和左甲狀腺素鈉片榦預組與健康對照組比較,胎膜早破、羊水異常、胎兒窘迫髮生率差異有統計學意義[25.3% (22/87)、31.4% (11/35)比10.6% (9/85),16.1% (14/87)、20.0%(7/35)比5.9% (5/85),27.6%(24/87)、34.3%(12/35)比10.6% (9/85),P<O.05],而妊娠期糖尿病、妊娠期高血壓、早產髮生率及有不良孕產史者佔比差異無統計學意義(P>0.05).單純TPOAb暘性組和左甲狀腺素鈉片榦預組比較,上述各項指標差異均無統計學意義(P>0.05).結論 妊娠期TPOAb暘性與妊娠期胎膜早破、羊水異常及胎兒窘迫相關.給予左甲狀腺素鈉片榦預後,妊娠期不良結跼仍與單純TPOAb暘性者相似.
목적 탐토갑상선과양화물매항체(TPOAb)양성잉부임신결국급진행림상간예적필요성.방법 선취2012년6월지2014년6월우상해교통대학의학원부속국제화평부유보건원취진병정기수방적단순TPOAb양성잉부122례.근거시부급여좌갑상선소납편장잉부분위단순TPOAb양성조(87례);좌갑상선소납편간예조(35례),발현촉갑상선소승고후급시급여좌갑상선소납편치료;령외선택동기분면적건강잉부85명작위건강대조조.임신기정기수방화평개갑상선공능,비교3조잉부임신기병발증급결국.결과 단순TPOAb양성조화좌갑상선소납편간예조여건강대조조비교,태막조파、양수이상、태인군박발생솔차이유통계학의의[25.3% (22/87)、31.4% (11/35)비10.6% (9/85),16.1% (14/87)、20.0%(7/35)비5.9% (5/85),27.6%(24/87)、34.3%(12/35)비10.6% (9/85),P<O.05],이임신기당뇨병、임신기고혈압、조산발생솔급유불량잉산사자점비차이무통계학의의(P>0.05).단순TPOAb양성조화좌갑상선소납편간예조비교,상술각항지표차이균무통계학의의(P>0.05).결론 임신기TPOAb양성여임신기태막조파、양수이상급태인군박상관.급여좌갑상선소납편간예후,임신기불량결국잉여단순TPOAb양성자상사.
Objective To analyze the pregnancy outcomes of women with positive thyroid peroxidase antibody (TPOAb) and discuss the necessity of clinical intervention.Methods Totally 122 pregnant women with positive TPOAb from June 2012 to June 2014 were enrolled and divided into pure positive TPOAb group (87 cases) with normal thyrotropin (TSH) and intervention group (85 cases) with increased TSH timely given levothyroxine sodium; in addition,85 healthy pregnant women were selected as control group.The thyroid function was followed up during gestation.The pregnancy complications and outcomes were compared among the three groups.Results The incidence of premature rupture of membranes,abnormal amniotic fluid and fetal distress in pure positive TPOAb group were significantly higher than those in intervention group and control group [25.3% (22/87),31.4% (11/35) vs 10.6% (9/85),16.1% (14/87),20.0% (7/35) vs 5.9% (5/85),27.6% (24/87),34.3% (12/87) vs 10.6% (9/85)] (P < 0.05).Gestational diabetes,gestational hypertension,abnormal gestation and birth,incidence of premature birth had no statistical differences among three groups.Above parameters were not significantly different between pure positive TPOAb group and intervention group (P > 0.05).Conclusion Positive TPOAb during pregnancy is associated with premature rupture of membranes; levothyroxine sodium intervention for those with increased TSH can not improve the poor pregnancy outcomes,which is similar to those with pure positive TPOAb.