Bussen S, Steck T
Department of Obstetrics and Gynecology, University of Würzburg, Germany.
Hum Reprod. 1995 Nov;10(11):2938-40. doi: 10.1093/oxfordjournals.humrep.a135823.
This study was undertaken to evaluate the incidence of thyroid autoantibodies in women with a history of recurrent (three or more consecutive) spontaneous abortions. A total of 22 euthyroid non-pregnant habitual aborters were analysed for thyreoglobulin and thyroid peroxidase antibodies; 22 nulligravidae and 22 multigravidae without endocrine dysfunction served as controls. Both thyroid antibodies were assayed using highly sensitive, commercially available enzyme-linked immunosorbent assay kits. Eight of the 22 women with recurrent spontaneous abortions (36%) but only two of the 22 nulligravidae controls (9%; chi 2 test, P = 0.03) and one of 22 multigravidae subjects (5%; chi 2 test, P < 0.01) demonstrated positive titres (> 100 IU/ml, as recommended by the manufacturer) of thyreoglobulin, thyroid peroxidase or both antibodies. The mean +/- SD antibody concentrations were 102.5 +/- 226.5 in the study versus 20.9 +/- 68.8 in the nulligravidae (U-test, P = 0.057) and 26.4 +/- 60.2 IU/ml (P = 0.097) in the multigravidae population for thyroid peroxidase, and 47.7 +/- 57.9 versus 24.1 +/- 31.9 (U-test, P = 0.051) and 28.1 +/- 27.9 IU/ml (P = 0.059) for thyreoglobulin. In conclusion, the incidence of thyroid antibodies in euthyroid women with habitual abortions appears to be significantly increased compared with the controls of reproductive age without previous abortions. Although the important issue of cause and effect has not been fully clarified, this finding suggests that thyroid antibodies may be a marker for autoimmune-mediated recurrent spontaneous abortions, not dissimilar to, for example, anticardiolipin.
本研究旨在评估有复发性(连续三次或更多次)自然流产史女性中甲状腺自身抗体的发生率。共分析了22例甲状腺功能正常的未孕习惯性流产者的甲状腺球蛋白和甲状腺过氧化物酶抗体;22例未孕女性和22例无内分泌功能障碍的经产妇作为对照。两种甲状腺抗体均使用高灵敏度的市售酶联免疫吸附测定试剂盒进行检测。22例复发性自然流产女性中有8例(36%),但22例未孕对照中只有2例(9%;卡方检验,P = 0.03),22例经产妇中有1例(5%;卡方检验,P < 0.01)甲状腺球蛋白、甲状腺过氧化物酶或两者抗体的滴度呈阳性(> 100 IU/ml,按照制造商推荐)。甲状腺过氧化物酶抗体浓度的均值±标准差在研究组中为102.5±226.5,未孕组为20.9±68.8(U检验,P = 0.057),经产妇组为26.4±60.2 IU/ml(P = 0.097);甲状腺球蛋白抗体浓度的均值±标准差在研究组中为47.7±57.9,未孕组为24.1±31.9(U检验,P = 0.051),经产妇组为28.1±27.9 IU/ml(P = 0.059)。总之,与无既往流产史的育龄对照相比,习惯性流产的甲状腺功能正常女性中甲状腺抗体的发生率似乎显著升高。尽管因果关系这一重要问题尚未完全阐明,但这一发现提示甲状腺抗体可能是自身免疫介导的复发性自然流产的一个标志物,与例如抗心磷脂并无不同。