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有习惯性流产或先兆子痫病史的女性的甲状腺自身免疫及其与非器官特异性抗体和甲状腺功能亚临床改变的关联。

Thyroid autoimmunity and its association with non-organ-specific antibodies and subclinical alterations of thyroid function in women with a history of pregnancy loss or preeclampsia.

作者信息

Mecacci F, Parretti E, Cioni R, Lucchetti R, Magrini A, La Torre P, Mignosa M, Acanfora L, Mello G

机构信息

Institute of Obstetrics and Gynaecology, University of Florence, Italy.

出版信息

J Reprod Immunol. 2000 Feb;46(1):39-50. doi: 10.1016/s0165-0378(99)00055-8.

Abstract

Following the observation that non-organ-specific antibodies are related with pregnancy loss and preeclampsia, the role of organ-specific antibodies is currently being extensively investigated. The aim of this study was on the one hand to evaluate the incidence of antithyroid antibodies in a study group of 69 women with a history of early pregnancy loss (subgroup 1), foetal death (subgroup 2) or preeclampsia (subgroup 3) and in a control group, on the other hand to assess the possible association of these autoantibodies with non-organ-specific antibodies and subclinical alterations of thyroid function in the study group. Antithyroid antibodies were present in 26/69 (37.7%) women of the study group (37.9% in subgroup 1; 40.9% in subgroup 2; 33.3% in subgroup 3) and in 10/69 (14.5%) of controls, the difference being statistically significant. A significant difference in the distribution of antibodies to thyroglobulin and thyroid peroxidase was found in subgroup 2. In the study group, the incidence of antiphospholipid antibodies was not significantly different in women positive (26.9%) and negative (34.9%) for antithyroid antibodies. Also, the overall incidence of subclinical alterations of thyroid function in the study group was significantly different in women positive (53.8%) and negative (16.2%) for thyroid autoimmunity (P<0.02). The results of this study seem to confirm the association between thyroid autoimmunity and obstetric complications and suggest the usefulness of undertaking prospective studies in order to evaluate the reproductive outcome of women with a history of recurrent abortion, foetal death or preeclampsia and positivity for antithyroid antibodies.

摘要

在观察到非器官特异性抗体与流产和先兆子痫有关后,目前正在广泛研究器官特异性抗体的作用。本研究的目的一方面是评估69名有早期流产史(亚组1)、胎儿死亡史(亚组2)或先兆子痫史(亚组3)的女性研究组以及对照组中抗甲状腺抗体的发生率,另一方面是评估这些自身抗体与研究组中非器官特异性抗体以及甲状腺功能亚临床改变之间的可能关联。研究组69名女性中有26名(37.7%)存在抗甲状腺抗体(亚组1中为37.9%;亚组2中为40.9%;亚组3中为33.3%),对照组中有10名(14.5%)存在抗甲状腺抗体,差异具有统计学意义。在亚组2中发现甲状腺球蛋白抗体和甲状腺过氧化物酶抗体的分布存在显著差异。在研究组中,抗甲状腺抗体阳性(26.9%)和阴性(34.9%)的女性中抗磷脂抗体的发生率无显著差异。此外,研究组中甲状腺功能亚临床改变的总体发生率在甲状腺自身免疫阳性(53.8%)和阴性(16.2%)的女性中也存在显著差异(P<0.02)。本研究结果似乎证实了甲状腺自身免疫与产科并发症之间的关联,并表明进行前瞻性研究以评估有反复流产、胎儿死亡或先兆子痫史且抗甲状腺抗体阳性的女性的生殖结局是有用的。

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