目的探讨孕妇妊娠早期促甲状腺激素(TSH)和甲状腺过氧化物酶抗体(TPOAb)筛查的重要性。方法以TSH值0.25～4.00μIU/mL为正常范围，根据TSH测定结果，将393例孕妇(孕周16～24周)分为甲状腺功能紊乱组141例，非甲状腺功能紊乱组252例。采用免疫放射法(IRMA)检测血清TSH，用电化学发光免疫分析法(ECLIA)检测TPOAb。结果甲状腺功能紊乱组TPOAb阳性率高达75.18%，非甲状腺功能紊乱组TPOAb阳性率达17.06%;149例TPOAb阳性的孕妇，其中有52例TSH异常(34.90%)，244例TPOAb阴性的孕妇，其中23例TSH异常(9.43%)。结论TPOAb阳性的孕妇甲状腺功能紊乱明显增加，TPOAb阳性孕妇的甲状腺功能有向亚临床甲状腺功能减退的趋势。
Objective To investigate importance of screening of thyroid stimulating hormone (TSH) and thyroid peroxidase antibody (TPOAb) in women with early pregnancy. Methods According to the testing results of thyroid function, the 393 pregnant women were divided into thyroid dysfunction group (141cases) and thyroid function group (252 cases). The TSH and TPOAb levels were determined by immunoradiometric assay electrochemiluminescence immunoassay respectively. Results The positive rate of TPOAb in thyroid dysfunction group and thyroid function group were 75.18%, and 17.06% respectively. There were 52 cases of TSH exceptional (34.9%) in 149 cases of TPOAb positive pregnant women, and 23 cases of TSH exceptional (9.43%) in 244 cases of TPOAb negative pregnant women. Conclusion The thyroid dysfunction of pregnant women with positive TPOAb are in disorder, and the TPOAb positive pregnancies show the tendency of sub-clinical hypothyroidism.
[1] 朱红,蒋优君,梁黎,等. 孕母自身甲状腺疾病对婴儿甲状腺功能的多因素分析[J]. 中华内分泌代谢杂志,2004,20(14):307-310.
[2] Baloch Z, Carayon P, Conte-Devolx B ,et al.Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease[J].Thyroid,2003,13(1):3-126.
[3] 董华,张遵城,李小东,等.妊娠早期检测甲状腺过氧化物酶抗体的临床价值[J].医学信息,2010,5(5):1105-1106.
[4] 潘云芳.抗甲状腺球蛋白抗体和抗甲状腺过氧化物酶抗体检测对甲状腺疾病的诊断价值[J].医学理论与实践,2010,23(7):852-853.
[5] 胡华杰.血清抗甲状腺过氧化物酶抗体检测在自身免疫性甲状腺疾病诊断中的意义[J].现代实用医学,2010,22(5):527-528.
[6] 胡欣,宾曼晖.甲状腺疾病不同功能状态的甲状腺过氧化物酶抗体水平分析[J].广西医学,2008,30(11):1701-1702.
[7] Lazarus J H. Thyroid disease in pregnancy and childhood[J].Minerva Endocrinol,2005,30(2):7l-87.
[8] Roti E,Uberti E.Post-partum thyroiditis-a clinical update[J].Eur J Endocrinol,2002,146(3):275-279.
[9] Ghafoor F, Mansoor M,Malik T,et al.Role of thyroid peroxidase antibodies in the outcome of pregnancy[J].J Coll Physicians Surg Pak,2006,16(7):468-471.
