抗甲状腺过氧化物酶抗体检测在妊娠早期的应用价值

摘要

目的：探究妊娠早期临床检测孕妇抗甲状腺过氧化物酶抗体（TPOAb）对于防治妊娠期间自身免疫性甲状腺功能紊乱的作用，判断TPOAb监测在临床中的应用价值及意义。方法：选取2014年6月-2015年12月在本院产检的孕妇（孕周<14周）240例作为研究对象，按其临床症状分为甲状腺功能紊乱组（观察组，106例）与非甲状腺功能紊乱组（对照组，134例），同时用罗氏COBAS E601分析仪和罗氏2010分析仪分别检测两组患者的TPOAb及TSH水平，并对两组患者的血糖、总胆固醇以及甘油三酯水平进行比较分析。结果：观察组患者的血清TPOAb和TSH水平均明显高于对照组，差异均有统计学意义（P<0.05），观察组患者的TPOAb阳性率达83.0%，对照组TPOAb阳性率达10.4%。240例孕妇中TPOAb阳性患者有102例，其中的88例（86.3%）血清TSH出现异常，TPOAb阴性患者138例，其中16例（11.6%）血清TSH出现异常，TPOAb阳性患者血清TSH异常率明显高于TPOAb阴性患者，比较差异有统计学意义（P<0.05）。观察组患者总胆固醇及甘油三酯水平均高于对照组，血糖水平低于对照组，比较差异均有统计学意义（P<0.05）；此外两组患者中自身抗体同性患者的血糖、总胆固醇及甘油三酯水平比较，差异均无统计学意义（P>0.05）。结论：临床检测孕妇的TPOAb是防治妊娠期间自身免疫性甲状腺功能紊乱的重要手段，妊娠早期加强对孕妇的TPOAb监测在临床应用中有重要的意义。%Objective:To explore effect of maternal anti thyroid peroxidase antibody(TPOAb) clinical detection for the prevention and treatment of autoimmune thyroid dysfunction during pregnancy,and then to judge the value and significance of TPOAb monitoring in the clinical application.Method:Two hundred and forty cases of pregnant women(gestational weeks<14) tested in our hospital from June 2014 to December 2015 were selected as the object and divided into the thyroid dysfunction group(the observation group,106 cases) and the non thyroid dysfunction group(the control group,134 cases) according to their clinical manifestations,the TPOAb and thyroid stimulating hormone(TSH) levels of the two groups were detected by Roche E601 COBAS analyzer and Roche 2010 analyzer respectively,as well as levels of blood glucose,total cholesterol and triglyceride.Result:The serum TPOAb levels and TSH levels of the observation group was significant higher compared with which of the control group, the difference was statistic significant(P<0.05),the positive rate of TPOAb in the observation group was 83.0%,while the control group was 10.4%.There were 102 cases of TPOAb positive patients in the 240 pregnant women,in which of 88 cases(86.3%) of abnormal serum TSH,the TPOAb negative patient were 138 cases,in which of 16 cases (11.6%) of abnormal serum TSH,the serum TSH abnormal rate of TPOAb positive patients were clear higher than the negative patients,the difference was statistic significant(P<0.05),which indicated that the thyroid dysfunction was significantly increased in TPOAb positive women.The total cholesterol and triglyceride levels of the observation group were higher than the control group,while the blood glucose of wich was lower than the control group,the differences were statistically significant(P<0.05).In addition,there were no obvious differences in blood glucose,total cholesterol and triglyceride levels between patients with identical antibodies (P>0.05).Conclusion:The clinical TPOAb detection of pregnant woman is an important means of the prevention and control on autoimmune thyroid disorders during pregnancy,strengthening TPOAb monitoring of pregnant women in the first trimester of pregnancy has an important significance in clinical application.