妊娠不同时期合并亚临床甲状腺功能减退孕妇血清甲状腺激素水平变化及其与TPO-Ab的相关性

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Abstract Objective To explore the changes of serum thyroid hormone level in pregnant women with subclinical hypothyroidism (“hypothysis” for short) at different stages of pregnancy and its correlation with thyroid peroxidase antibody (TPO-Ab). Methods A retrospective analysis of 83 pregnant women with subclinical hypothysis admitted to Fuyang Women’s and Children’s Hospital of Anhui Province from March 2018 to March 2021 who underwent prenatal examination and delivered were enrolled as the observation group. According to gestational age, 26 patients were divided into the early gestational age (1-12 weeks), 29 patients in the middle gestational age (13-27 weeks), and 28 patients in the late gestational age (≥28 weeks); in addition, 83 pregnant women with normal thyroid function who underwent prenatal examination during the same period were selected as the control group. The serum thyroid hormones [thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4)] and TPO-Ab levels of all subjects were detected, TPO-Ab level > the upper limit of the reference value provided by the kit was considered TPO-Ab positive, and the correlation between TSH, FT4, FT3, and TPO-Ab positive was analyzed. Results The levels of TSH and TPO-Ab in the observation group were higher than those in the control group, the level of FT3 was lower than that in the control group, and the differences were statistically significant (P < 0.05); while there was no significant difference in FT4 between the two groups (P > 0.05). There were no significant differences in the levels of TSH, FT4, FT3, and TPO-Ab in the different pregnancy stages of the control group (P > 0.05). In the observation group， the levels of TSH and TPO-Ab in the third trimester of pregnancy were higher than those in the first and second trimesters of pregnancy, and the second trimester of pregnancy was higher than the first trimester of pregnancy; the level of FT3 in the third trimester of pregnancy was lower than that in the first and second trimesters of pregnancy, and the second trimester of pregnancy was lower than the first trimester of pregnancy, and the differences were statistically significant (P < 0.05); there were no significant differences in the levels of FT4 at different pregnancy stages (P > 0.05). There were statistically significant differences in the levels of TSH, FT4, FT3, and TPO-AB between the two groups during pregnancy (P < 0.05); there were no statistical significance differences in the levels of FT4 between the two groups during different pregnancy (P > 0.05). There was no statistically significant difference in the total incidence of pregnancy outcomes of mothers and infants with adverse pregnancy in the observation group (P > 0.05). Serum TSH was positively correlated with the positive rate of TPO-Ab (r = 0.513, P < 0.05); FT3 was negatively correlated with the positive rate of TPO-Ab (r = -0.245, P < 0.05). Conclusion The levels of serum TSH and FT3 in pregnant women with subclinical hypothysis were related to the positive rate of TPO-Ab, and strengthening the monitoring of TPO-Ab can timely judge the changes of thyroid related functional indexes.

Key words： Thyroid peroxidase antibody Subclinical hypothyroidism Thyroid stimulating hormone Free thyroxine

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	LIU Guiying ZHOU Xiuyun

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LIU Guiying ZHOU Xiuyun. Changes of serum thyroid hormone level in pregnant women with subclinical hypothyroidism at different stages of pregnancy and its correlation with TPO-Ab[J]. 中国医药导报, 2022, 19(15): 113-116.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I15/113

[1] 王秀丽，颜珊，方建红.妊娠合并甲状腺功能减退患者血清TSH、叶酸、Hcy表达水平及其临床意义[J].中国妇产科临床杂志，2021，22（3）：240-242.
[2] 唐萍，王其美.妊娠期亚临床甲减孕妇不同孕期TSH水平变化及对低出生体重儿的预测价值研究[J].中国妇产科临床杂志，2021，22（3）：246-248.
[3] 王凯亮，朱海清，韩旸，等.妊娠期妇女甲状腺功能减退对妊娠结局及子代智力的影响[J].中国医刊，2020，55（2）：139-142.
[4] 刘玉芳，张晓梅，柴三葆，等.娠期亚临床甲状腺功能减退症对妊娠结局和后代的影响[J].中华内分泌代谢杂志，2017，33（3）：269-272.
[5] Karcaaltincaba D，Ozek MA，Ocal N，et al. Prevalences of subclinical and overt hypothyroidism with universal screening in early pregnancy [J]. Arch Gynecol Obstet，2020， 301（3）：681-686.
[6] 中华医学会内分泌学分会，中华医学会围产医学分会.妊娠和产后甲状腺疾病诊治指南[J].中华内分泌代谢杂志，2012，28（5）：354-371.
[7] Stagnaro-Green A，Abalovich M，Alexander E，et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum [J]. Thyroid，2011，21（10）：1081-1125.
[8] Neelaveni K，Kumar KVSH，Sahay R，et al. Postpartum Follow-up in Women Diagnosed with Subclinical Hypothyroidism during Pregnancy [J]. Indian J Endocrinol Metab，2017，21（5）：699-702.
[9] Yoshihara H，Sugiura-Ogasawara M，Goto S，et al. Levothyroxine and subclinical hypothyroidism in patients with recurrent pregnancy loss [J]. Am J Reprod Immunol，2021， 85（3）：e13341.
[10] 王小菊，龙燕，蔺莉.不同TSH水平妊娠期亚临床甲减孕妇妊娠结局的前瞻性队列研究[J].中国妇产科临床杂志，2019，20（5）：410-413.
[11] 许诗珺，范建霞，杨帅，等.不同促甲状腺激素和游离甲状腺素检测试剂对妊娠期甲状腺功能检测结果的影响[J].中华围产医学杂志，2015，18（2）：81-86.
[12] Gietka-Czernel M，Glinicki P. Subclinical hypothyroidism in pregnancy：controversies on diagnosis and treatment [J]. Pol Arch Intern Med，2021，131（3）：266-275.
[13] 张芳英，杨平，罗惠娟，等.不同孕期特异性甲状腺激素水平探讨[J].暨南大学学报（自然科学与医学版），2018， 39（6）：512-516.
[14] 白宇，陈奇，厉平，等.不同血清促甲状腺激素水平的妊娠期妇女左甲状腺素治疗剂量分析[J].中国实用内科杂志，2021，41（7）：609-612.
[15] 朱文元，向菲，杨洪芬，等.贵阳市观山湖区妊娠期妇女碘营养状况与甲状腺激素水平的相关性研究[J].中华地方病学杂志，2018，37（1）：54-58.
[16] Xue D，Sun JL，Yang J. Early L-T4 intervention improves fetal heart development in pregnant rats with subclinical hypothyroidism rats by activating BMP4/Smad4 signaling pathway [J]. BMC Cardiovasc Disord，2020，20（1）：369.
[17] 周庆调，郑建琼，张红萍.晚孕期不同水平促甲状腺素与妊娠期代谢综合征及其组分的相关性[J].实用医学杂志，2017，33（24）：4137-4140.
[18] Rao M，Zeng Z，Zhou F，et al. Effect of levothyroxine supplementation on pregnancy loss and preterm birth in women with subclinical hypothyroidism and thyroid autoimmunity：a systematic review and meta-analysis [J]. Hum Reprod Update，2019，25（3）：344-361.
[19] 杨雨溪，刘瑞霞，阴赪宏.妊娠期TPO-Ab阳性亚临床甲状腺功能减退症对妊娠结局的影响[J].中国妇产科临床杂志，2021，22（1）：108-110.
[20] 李霞，孙丽洲.甲状腺疾病对母婴妊娠结局的影响[J].南京医科大学学报（自然科学版），2019，39（10）：1511-1514.
[21] Hamblin PS，Sheehan PM，Allan C，et al. Subclinical hypothyroidism during pregnancy：the Melbourne public hospitals consensus [J]. Intern Med J，2019，49（8）：994-1000.
[22] 何玉花，吴敏，徐凤英.妊娠早期抗甲状腺过氧化物酶阴性亚临床甲状腺功能减退症妊娠结局研究[J].中国实用妇科与产科杂志，2019，35（3）：339-342.
[23] 班彦杰，许雅娟，孙宗宗，等.妊娠期甲状腺功能减退症与自然流产关系研究[J].中国实用妇科与产科杂志，2020，36（6）：552-554.
[24] 宋晶，陈奕.孕早期脂代谢异常对妊娠并发症及妊娠结局的影响[J].中国妇产科临床杂志，2020，21（3）：275-276.
[25] 陈华，吴艳乔，吴亚.亚临床甲减及TPOAb阳性对孕妇子痫前期临床结局的影响[J].临床和实验医学杂志，2020，19（22）：2434-2438.
[26] 李洲成，彭菲，向元楚，等.干预治疗对妊娠期亚临床甲减妊娠结局的影响[J].中外医学研究，2021，19（5）：4-6.
[27] 周臣敏，李瑾，王孝君.孕早期甲状腺功能筛查预防妊娠合并亚临床甲减的效果及对妊娠结局的影响[J].中国妇幼保健，2018，33（10）：2211-2214.