孕期及产后抗甲状腺抗体滴度的变化
Variations in the Antithyroid Antibody Titre During Pregnancy and After Delivery.
作者信息
Li Chuyu, Zhang Na, Zhou Jing, Leung Wingting, Gober Hans-Jürgen, Huang Zengshu, Pan Xinyao, Chen Lijia, Guan Liang, Wang Ling
机构信息
Laboratory for Reproductive Immunology, Hospital & Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
The Academy of Integrative Medicine of Fudan University, Shanghai, People's Republic of China.
出版信息
Risk Manag Healthc Policy. 2021 Mar 1;14:847-859. doi: 10.2147/RMHP.S279975. eCollection 2021.
BACKGROUND
Immunosuppression occurs during pregnancy, and the antithyroid antibody titre drops, rebounding after delivery. We aimed to determine variations in antithyroid antibody titres during pregnancy and after delivery.
METHODS
This retrospective study was conducted in a single centre. Antibody titres of 142 patients were measured to assess variations in the levels of thyroid-stimulating hormone receptor antibodies (TRAbs), thyroid peroxidase antibodies (TPOAbs), and thyroid globulin antibodies (TgAbs). We compared the titres of each antibody between adjacent time periods (eg, first trimester (T1) vs second trimester (T2), T2 vs third trimester (T3), T3 vs the postpartum period (PP)) by paired -test or the Wilcoxon test. Then, we analysed data from patients with complete laboratory examination results in all four periods with the Friedman test, performing comparisons among groups.
RESULTS
In the TgAb group, significant differences existed between T1 and T2 and between T2 and T3 in the LT4 subgroup and between T1 and T2 in the no-medication subgroup. In the TRAb group, significant differences existed between T1 and T2 in the LT4 subgroup. In the TPOAb group, significant differences existed among each group in the LT4 subgroup, and there were significant differences between T1 and T2 and between T2 and T3 in the no-medication subgroup. The Friedman test showed that the P-values were 0.013 and 0.004 in the LT4 and no-medication subgroups of the TgAb group, respectively; 0.122 in the LT4 subgroup of the TRAb group; and <0.001 and 0.272 in the LT4 and no-medication subgroups of the TPOAb group, respectively. In the LT4 subgroup of the TgAb group, the P-values for comparisons of time periods were 0.602 between T1 and T2, 0.602 between T2 and T3, 0.006 between T1 and T3, and 0.602 between T3 and PP. In the no-medication subgroup of the TgAb group, the P-values were 0.078 between T1 and T2, 1.000 between T2 and T3, 0.011 between T1 and T3, and 0.078 between T3 and PP. In the LT4 subgroup of the TPOAb group, the P-values were 0.09 between T1 and T2, 0.014 between T2 and T3, <0.001 between T1 and T3, and 0.772 between T3 and PP.
CONCLUSION
We can conclude that the TgAb and TPOAb titres dropped during pregnancy.
背景
孕期会出现免疫抑制，抗甲状腺抗体滴度下降，产后反弹。我们旨在确定孕期及产后抗甲状腺抗体滴度的变化。
方法
本回顾性研究在单一中心进行。测量了142例患者的抗体滴度，以评估促甲状腺激素受体抗体（TRAb）、甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TgAb）水平的变化。我们通过配对t检验或Wilcoxon检验比较相邻时间段（如孕早期（T1）与孕中期（T2）、T2与孕晚期（T3）、T3与产后时期（PP））每种抗体的滴度。然后，我们使用Friedman检验分析所有四个时期实验室检查结果完整的患者的数据，并进行组间比较。
结果
在TgAb组中，LT4亚组的T1与T2之间以及T2与T3之间存在显著差异，未用药亚组的T1与T2之间存在显著差异。在TRAb组中，LT4亚组的T1与T2之间存在显著差异。在TPOAb组中，LT4亚组的各组之间存在显著差异，未用药亚组的T1与T2之间以及T2与T3之间存在显著差异。Friedman检验显示，TgAb组的LT4和未用药亚组的P值分别为0.013和0.004；TRAb组的LT4亚组为0.122；TPOAb组的LT4和未用药亚组分别为<0.001和0.272。在TgAb组的LT4亚组中，时间段比较的P值在T1与T2之间为0.602，T2与T3之间为0.602，T1与T3之间为0.006，T3与PP之间为0.602。在TgAb组的未用药亚组中，P值在T1与T2之间为0.078，T2与T3之间为1.000，T1与T3之间为0.011，T3与PP之间为0.078。在TPOAb组的LT4亚组中，P值在T1与T2之间为0.09，T2与T3之间为0.014，T1与T3之间为<0.001，T3与PP之间为0.772。
结论
我们可以得出结论，孕期TgAb和TPOAb滴度下降。
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