CAJ | 학술논문

目的：分析西安市中心医院妊娠妇女甲状腺功能及抗体异常的发生率和特点。方法选取在妇产科门诊首次进行妊娠诊断和产前检查的妊娠妇女共1683例为观察对象，其中1326例无甲状腺疾病史或家族史，357例有甲状腺疾病史或家族史。应用电化学发光法测定血清游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）、总甲状腺素（TT4）、总三碘甲状腺原氨酸（TT3）、促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPO‐Ab）、抗甲状腺球蛋白抗体（Tg A b ）。结果（1）1326例无甲状腺疾病史及家族史的妊娠妇女组中，亚临床甲状腺功能减退为25．9％（344例），甲减为8．3％（110例），甲亢为2．3％（31例）；357例有甲状腺疾病史或家族史的妊娠妇女组中，亚临床甲减为36．7％（131例），甲减11．8％（42例），甲亢为2．8％（10例）。（2）有甲状腺疾病史或家族史的妊娠妇女，无论TPOAb和（或）TgAb抗体水平是否增高，甲状腺功能异常发生率明显高于无甲状腺疾病史或家族史的妊娠妇女（χ2＝35．82，P＜0．01）。（3）TPOAb或TgAb升高的妊娠妇女，无论有无甲状腺疾病史或家族史，甲状腺功能异常的发生率明显高于TPOAb或TgAb水平正常的妊娠妇女（χ2＝78．94，P＜0．01）。（4）妊娠T1、T2、T3期的妇女甲状腺功能异常发生率呈上升趋势，分别为33．8％、36．0％、43．0％。结论应积极倡导对所有备孕及孕早期妇女进行甲状腺功能及甲状腺自身抗体的全面筛查，并参照ATA规定的妊娠期特异的血清 TSH参考值，对有甲状腺疾病史及家族史、抗体水平增高的妊娠妇女要求定期复查。
목적：분석서안시중심의원임신부녀갑상선공능급항체이상적발생솔화특점。방법선취재부산과문진수차진행임신진단화산전검사적임신부녀공1683례위관찰대상，기중1326례무갑상선질병사혹가족사，357례유갑상선질병사혹가족사。응용전화학발광법측정혈청유리갑상선소（FT4）、유리삼전갑상선원안산（FT3）、총갑상선소（TT4）、총삼전갑상선원안산（TT3）、촉갑상선격소（TSH）、갑상선과양화물매항체（TPO‐Ab）、항갑상선구단백항체（Tg A b ）。결과（1）1326례무갑상선질병사급가족사적임신부녀조중，아림상갑상선공능감퇴위25．9％（344례），갑감위8．3％（110례），갑항위2．3％（31례）；357례유갑상선질병사혹가족사적임신부녀조중，아림상갑감위36．7％（131례），갑감11．8％（42례），갑항위2．8％（10례）。（2）유갑상선질병사혹가족사적임신부녀，무론TPOAb화（혹）TgAb항체수평시부증고，갑상선공능이상발생솔명현고우무갑상선질병사혹가족사적임신부녀（χ2＝35．82，P＜0．01）。（3）TPOAb혹TgAb승고적임신부녀，무론유무갑상선질병사혹가족사，갑상선공능이상적발생솔명현고우TPOAb혹TgAb수평정상적임신부녀（χ2＝78．94，P＜0．01）。（4）임신T1、T2、T3기적부녀갑상선공능이상발생솔정상승추세，분별위33．8％、36．0％、43．0％。결론응적겁창도대소유비잉급잉조기부녀진행갑상선공능급갑상선자신항체적전면사사，병삼조ATA규정적임신기특이적혈청 TSH삼고치，대유갑상선질병사급가족사、항체수평증고적임신부녀요구정기복사。
Objective To analyze the occurrence rate and characteristics of thyroid function and antibodies ab‐normalities among 1 686 pregnant women in our hospital .Methods 1 683 pregnant women with first pregnant diag‐nosis and prenatal examination in the obstetrics and gynecology outpatient department of our hospital were selected as the observation subjects ,among them 1 326 cases had no the thyroid disease history or family history (group A) and 357 cases had thyroid disease history or family history (group B) .Serum FT4 ,FT3 ,TT4 ,TT3 ,TSH ,TPO‐Ab and TgAb were measured with electrochemiluminescence(ECL) .Results (1)In the group A ,subclinical hypothyroidism accounted for 25 .94% (344 cases) ,hypothyroidism for 8 .3% (110 cases) and hyperthyroidism for 2 .3% (31 cases);in the group B ,subclinical hypothyroidism accounted for 36 .7% (131 cases) ,hypothyroidism for 11 .8% (42 cases) and hyperthyroidism for 2 .8% (10 cases) .(2)No matter TPOAb or/and TgAb antibody levels were increased or not , the incidence rate of abnormal thyroid function in the pregnant women with thyroid disease history or family history was significantly higher than that in the pregnant women without thyroid disease history or family history disease (χ2 =35 .82 ,P<0 .01) .(3) No matter with or without thyroid disease history or family history ,the incidence rate of abnormal thyroid function in the pregnant women with TPOAb or TgAb level increase was significantly higher than that in the pregnant women with normal TPOAb or TgAb levels (χ2 =78 .94 ,P<0 .01) .(4)The incidence rate of ab‐normal thyroid function in the T1 ,T2 ,T3 trimesters of pregnant women showed the increasing trend ,which were 33 .8% ,36 .0% and 43 .0% respectively .Conclusion It is actively advocated that the women preparing for pregnancy and early pregnancy women should perform the comprehensively examination of thyroid function and thyroid au‐toantibodies ,the pregnant women with thyroid disease history ,family history and high levels of thyroid antibodies are suggested to do regular re‐examinations by referring to pregnant stage specific serum TSH reference value regulated by ATA .