探讨乙型肝炎病毒感染妊娠早期产妇的甲状腺功能
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摘要
目的:探讨乙型肝炎病毒(HBV)感染产妇进行妊娠早期的甲状腺功能检测的临床价值。方法:选取2017-01—2018-06进行产前检查的HBV阳性产妇347例作为研究组,另取同期进行产前检查的HBV阴性产妇347例作为对照组。对2组的一般临床资料、甲状腺功能指标(FT3、FT4、TSH)及妊娠结局等指标进行对比分析。结果:2组FT3及FT4含量水平,差异无统计学意义(P>0.05);研究组平均TSH水平显著低于对照组,差异有统计学意义(P<0.05)。研究组TSH降低比例显著高于对照组,差异有统计学意义(P<0.05)。研究组不良妊娠结局评分显著高于对照组,差异有统计学意义(P<0.05)。结论:妊娠早期的甲状腺功能检测有助于HBV阳性孕妇的甲状腺疾病检测,以便进行早期干预,避免不良的妊娠结局。
Objective:To investigate the clinical value of thyroid function detection in early pregnancy in maternal HBV infection patients. Method:A total of 347 HBV-positive women who underwent prenatal examination in our hospital from January 2017 to June 2018 were selected as study groups.A total of 154 HBV-negative mothers who underwent prenatal examination were selected as the control group.The general clinical data,thyroid function indexes(FT3,FT4,TSH)and pregnancy outcomes of the two groups were compared and analyzed. Result:The mean age of the study group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).There were no significant differences in the levels of FT3 and FT4 between the two groups(P>0.05).The average TSH level in the study group was significantly lower than that in the control group(P<0.05).The reduction rate of TSH in the study group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The adverse pregnancy outcome scores of the study group were significantly higher than the control group,and the difference was statistically significant(P<0.05).Conclusion:Early pregnancy tests for thyroid function would help detecting thyroid disease in HBV-positive pregnant women for early intervention to avoid adverse pregnancy outcomes.
Objective:To investigate the clinical value of thyroid function detection in early pregnancy in maternal HBV infection patients. Method:A total of 347 HBV-positive women who underwent prenatal examination in our hospital from January 2017 to June 2018 were selected as study groups.A total of 154 HBV-negative mothers who underwent prenatal examination were selected as the control group.The general clinical data,thyroid function indexes(FT3,FT4,TSH)and pregnancy outcomes of the two groups were compared and analyzed. Result:The mean age of the study group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).There were no significant differences in the levels of FT3 and FT4 between the two groups(P>0.05).The average TSH level in the study group was significantly lower than that in the control group(P<0.05).The reduction rate of TSH in the study group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The adverse pregnancy outcome scores of the study group were significantly higher than the control group,and the difference was statistically significant(P<0.05).Conclusion:Early pregnancy tests for thyroid function would help detecting thyroid disease in HBV-positive pregnant women for early intervention to avoid adverse pregnancy outcomes.
引文
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[16]Cramer JP,Dubischar K,Eder S,et al.Immunogenicity and safety of the inactivated Japanese encephalitis vaccine IXIARO?in elderly subjects:Open-label,uncontrolled,multi-center,phase 4study[J].Vaccine,2016,34:4579-4585.
[17]Xu Z,Shen J,Pan X,et al.Predictive value of serum Golgi protein 73for prominent hepatic necroinflammation in chronic HBV infection[J].J Med Virol,2018,90:1053-1062.
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[19]Vargas JI,Jensen D,Sarmiento V,et al.Presence of anti-HBc is associated to high rates of HBV resolved infection and low threshold for Occult HBV Infection in HIV patients with negative HBsAg in Chile[J].JMed Virol,2016,88:639-646.
[20]Tan Z,Yin Y,Zhou J,et al.Telbivudine treatment of hepatitis B virus-infected pregnant women at different gestational stages for the prevention of mother-tochild transmission:Outcomes of telbivudine treatment during pregnancy[J].Medicine,2016,95:e4847.
[2]Veltri F,Kleynen P,Grabczan L,et al.Pregnancy outcomes are not altered by variation in thyroid function within the normal range in women free of thyroid disease[J].Eur J Endocrinol,2018,178:189-197.
[3]储建中,叶光明.乙型肝炎病毒基因型与耐药突变基因的检测分析[J].临床血液学杂志,2017,2(12):911-913.
[4]Kolasa MS,Tsai Y,Xu J,et al.Hepatitis B Surface Antigen Testing Among Pregnant Women,United States2014[J].Pediatr Infect Dis J,2017,36:e175-e180.
[5]王国成,麻伟博,孙红敏,等.妊娠期甲状腺疾病及其相关诊断指标的参考值范围研究现状[J].中华妇幼临床医学杂志(电子版),2017,13(5):12-19.
[6]丁榕,范建霞.美国甲状腺学会《2017年妊娠及产后甲状腺疾病诊治指南》解读[J].中华围产医学杂志,2017,20(3):44-45.
[7]Fetene DM,Betts KS,Alati R.MECHANISMS INENDOCRINOLOGY:Maternal thyroid dysfunction during pregnancy and behavioural and psychiatric disorders of children:a systematic review[J].Eur J Endocrinol,2017,177:R261-R273.
[8]Furcron AE,Romero R,Mial TN,et al.Human Chorionic Gonadotropin Has Anti-Inflammatory Effects at the Maternal-Fetal Interface and Prevents EndotoxinInduced Preterm Birth,but Causes Dystocia and Fetal Compromise in Mice1[J].Biol Reprod,2016,94:136.
[9]Gillozano M,Wu WK,Martchenko A,et al.High-fat diet and palmitate alter the rhythmic secretion of glucagon-like peptide-1by the rodent L-cell[J].Endocrinology,2016,157:586-599.
[10]Shimodaira M,Okaniwa S,Nakayama T.Investigation of the relationship between hemoglobin and serum iron levels and early-phase insulin secretion in non-diabetic subjects[J].Acta Diabetologica,2016,53:1-7.
[11]Namiki S,Mitsuzuka K,Kaiho Y,et al.Serum luteinizing hormone concentration is significantly associated with recovery of urinary function after radical prostatectomy[J].BJU Int,2016,117:450-455.
[12]Sheng N,Li J,Liu H,et al.Interaction of perfluoroalkyl acids with human liver fatty acid-binding protein[J].Arch Toxicol,2016,90:217-227.
[13]Wang Q,Li J,Lei Z,et al.Prognosis of Intrahepatic Cholangiocarcinomas with HBV Infection is Better than Those with Hepatolithiasis After R0Liver Resection:A Propensity Score Matching Analysis[J].Ann Surg Oncol,2017,24:1579-1587.
[14]Veltri F,Belhomme J,Kleynen P,et al.Maternal thyroid parameters in pregnant women with different ethnic backgrounds:do ethnicity-specific reference ranges improve the diagnosis of subclinical hypothyroidism?[J].Clin Endocrinol,2017,86:830.
[15]Korevaar TI,Steegers EA,Chaker L,et al.The Risk of Preeclampsia According to High Thyroid Function in Pregnancy Differs by hCG Concentration[J].J Clin Endocrinol Metab,2016,101:5037-5043.
[16]Cramer JP,Dubischar K,Eder S,et al.Immunogenicity and safety of the inactivated Japanese encephalitis vaccine IXIARO?in elderly subjects:Open-label,uncontrolled,multi-center,phase 4study[J].Vaccine,2016,34:4579-4585.
[17]Xu Z,Shen J,Pan X,et al.Predictive value of serum Golgi protein 73for prominent hepatic necroinflammation in chronic HBV infection[J].J Med Virol,2018,90:1053-1062.
[18]Maini MK,Gehring AJ.The role of innate immunity in the immunopathology and treatment of HBV infection[J].J Hepatol,2016,64:S60-S70.
[19]Vargas JI,Jensen D,Sarmiento V,et al.Presence of anti-HBc is associated to high rates of HBV resolved infection and low threshold for Occult HBV Infection in HIV patients with negative HBsAg in Chile[J].JMed Virol,2016,88:639-646.
[20]Tan Z,Yin Y,Zhou J,et al.Telbivudine treatment of hepatitis B virus-infected pregnant women at different gestational stages for the prevention of mother-tochild transmission:Outcomes of telbivudine treatment during pregnancy[J].Medicine,2016,95:e4847.