妊娠期肝内胆汁淤积患者血清促甲状腺激素、甲状腺过氧化物酶抗体水平变化及临床意义

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摘要目的探讨妊娠期肝内胆汁淤积（ICP）患者血清促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）水平变化及临床意义。方法选取2015年3月～2017年3月湖北省荆州市第二人民医院（以下简称“我院”）收治的ICP患者120例作为观察组。根据ICP患者不同病情严重程度将患者分为轻度组（n = 59）、重度组（n = 61），另选取同期于我院正常体检的60名健康孕妇为对照组。采用酶联免疫吸附试验法检测血清中TSH、TPOAb水平，比较对照组与观察组受试者的血清TSH、TPOAb水平，比较不同ICP病情严重程度产妇血清TSH、TPOAb水平，采用Pearson相关性分析血清TSH、TPOAb相关性，记录对照组与观察组新生儿并发症的发生率以及受试者不良妊娠结局情况。结果观察组血清TSH、TPOAb水平显著高于对照组，差异有统计学意义（P < 0.05）。重度组孕妇血清TSH、TPOAb水平高于轻度组，差异有统计学意义（P < 0.05）。观察组新生儿并发症总发生率、不良妊娠结局总发生率均高于对照组，差异有统计学意义（P < 0.05）。经Pearson相关性分析显示，ICP患者血清TSH、TPOAb与ICP病情严重程度均呈正相关（r = 0.532、0.503，P < 0.05）。结论 ICP患者血清TSH、TPOAb水平呈高表达，且随着ICP病情程度的加重，其水平不断升高，临床可考虑将上述血清学指标作为诊断ICP的生物学指标之一。

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	庞连胜赵万春

关键词 ：妊娠期肝内胆汁淤积, 促甲状腺激素, 甲状腺过氧化物酶抗体, 临床意义

Abstract：Objective To investigate the changes and clinical significance of serum thyrotropin (TSH) and thyroid peroxidase antibody (TPOAb) level in patients with intrahepatic cholestasis in pregnancy (ICP). Methods A total of 120 patients with ICP admitted to the Second People′s Hospital of Jingzhou City in Hubei Province ("our hospital" for short) from March 2015 to March 2017 was selected as observation group. The patients of observation group were divided into mild group (n = 59) and severe group (n = 61) according to the severity of ICP. Another 60 healthy pregnant women who had normal physical examination in our hospital during the same period were selected as control group. The serum TSH and TPOAb level was measured by enzyme-linked immunosorbent assay. The serum TSH and TPOAb level of control group and observation group was compared. Change of serum TSH and TPOAb level of the pregnant women with different severity of ICP was compared. Pearson correlation analysis was used to analyze the correlation between serum TSH and TPOAb. The incidence of neonatal complications and adverse pregnancy outcomes in control group and observation group was recorded. Results The serum TSH and TPOAb levels in observation group were significantly higher than those in control group, the differences were statistically significant (P < 0.05). The serum TSH and TPOAb levels of severe group were higher than those in mild group, the differences were statistically significant (P < 0.05). The total incidence of neonatal complications and adverse pregnancy outcomes in observation group were higher than those in control group, the differences were statistically significant (P < 0.05). Pearson correlation analysis showed that serum TSH and TPOAb was positively correlated with the severity of ICP (r = 0.532, 0.503, P < 0.05). Conclusion The level of serum TSH and TPOAb of ICP patients is highly expressed. With the aggravation of ICP, the level of TSH and TPOAb increased continuously. The above serological indicators can be considered as one of the biological indicators for the diagnosis of ICP.

Key words： Intrahepatic cholestasis in pregnancy Thyrotropin Thyroid peroxidase antibody Clinical significance

基金资助:湖北省科学技术厅课题（EK2013D160002000066）。

引用本文:

庞连胜赵万春. 妊娠期肝内胆汁淤积患者血清促甲状腺激素、甲状腺过氧化物酶抗体水平变化及临床意义[J]. 中国医药导报, 2019, 16(16): 159-162.
PANG Liansheng ZHAO Wanchun. Changes and clinical significance of serum thyrotropin and thyroid peroxidase antibody level in patients with intrahepatic cholestasis in pregnancy. 中国医药导报, 2019, 16(16): 159-162.

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