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中国临床药理学与治疗学 ›› 2019, Vol. 24 ›› Issue (1): 71-76.doi: 10.12092/j.issn.1009-2501.2019.01.012

• 药物治疗学 • 上一篇    下一篇

妊娠期妇女甲状腺功能检测在子痫前期的诊断价值研究

蔡海瑞，程淑清，刘喜娟，陈安儿   

  1. 宁波市妇女儿童医院妇产科，宁波 315012，浙江
  • 收稿日期:2018-09-16 修回日期:2018-10-29 出版日期:2019-01-26 发布日期:2019-01-25
  • 作者简介:蔡海瑞，女，研究生，主治医师，研究方向：妇产科。 E-mail：chr3124681@126.com
  • 基金资助:

    GPⅡb/Ⅲa蛋白基因多态性与子痫前期相关性的研究（2018A610329）

Diagnostic value of thyroid function in pregnant women with pre-eclampsia

CAI Hairui，CHENG Shuqing，LIU Xijuan, CHEN Aner   

  1. Department of Gynecology, Women and Children Hospital of Ningbo, Ningbo 315012, Zhejiang, China
  • Received:2018-09-16 Revised:2018-10-29 Online:2019-01-26 Published:2019-01-25

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摘要：

目的: 分析妊娠期妇女甲状腺功能检测在子痫前期（PE）中的诊断价值，为妊娠期妇女PE的早期诊断与治疗提供参考。方法: 选取2015年3月至2017年2月来本院就诊的41例PE患者为观察组，选取同时期参与体检的29名健康妊娠期妇女为对照组，比较两组血清中的游离甲状腺素（FT4）、促甲状腺激素（TSH）及甲状腺过氧化物酶抗体（TPOAb）水平；采用ROC曲线分析FT4、TSH、TPOAb检测及三项指标联合检测对PE的诊断价值，比较各检测方法对PE诊断的阳性及阴性预测值、灵敏度、特异度、一致性及ROC曲线下面积（AUC）。结果: 观察组的TSH水平及TPOAb阳性率均显著高于对照组（P<0.05），FT4水平显著低于对照组（P<0.05）；FT4、TSH、TPOAb检测及三项指标联合检测诊断PE的阳性预测值分别为：0.871，0.917，0.848，0.923；阴性预测值分别为：0.641，0.765，0.649，0.839；敏感度分别为：0.659，0.805，0.683，0.878；特异度分别为：0.862，0.897，0.828，0.897；Kappa值分别为0.496，0.684，0.491，0.767；AUC分别为0.620，0.706，0.675，0.775，三项联合诊断的AUC显著高于FT4、TSH及TPOAb的单独检测（P<0.05）。结论: 妊娠期妇女甲状腺各项功能指标检测在PE的诊断中均有较高的应用价值，且三项指标联合检测的诊断价值最高。

关键词: 妊娠期, 甲状腺功能, 子痫前期, 诊断价值

Abstract:

AIM: To investigate the diagnostic value of thyroid function in pregnant women with pre-eclampsia (PE) so as to provide reference for the diagnosis and early treatment of pregnant women with PE.  METHODS: Forty-one patients with PE in our hospital were selected from Mar.2015 to Feb.2017 for the observation group, 29 healthy pregnant women who were participate in physical examination at the same time were selected for the control group. The levels of free thyroxine (FT4), thyroid stimulating hormone (TSH) and thyroid peroxidase autoantibody (TPOAb) were compared between groups. ROC curve was used to analyze the diagnostic value of FT4, TSH, TPOAb detection and the joint detection of three indicators for PE, and the positive and negative prediction rate, sensitivity, specific, consistency and area under curve (AUC) of the detection results were compared. RESULTS: The level of TSH and TPOAb in observation group were significantly higher than those in control group (P<0.05), and the level of FT4 in observation group was significantly lower than that in control group (P<0.05). The positive predictive value of FT4, TSH, TPOAb detection and joint detection were 0.871, 0.917, 0.848 and 0.923, the negative predictive value were 0.641, 0.765, 0.649 and 0.839, the sensitivity were 0.659, 0.805, 0.683 and 0.878, the specificity were 0.862, 0.897, 0.828 and 0.897, the value of Kappa were 0.496, 0.684, 0.491 and 0.767, the AUC were 0.620, 0.706, 0.675 and 0.775. The AUC of joint detection is significantly higher than FT4 level detection, TSH level detection and TPOAb level detection (P<0.05). CONCLUSION: Each index detection of thyroid function has high diagnostic value in pregnant women with PE, and the highest diagnostic value of PE is joint detection.

Key words: pregnant, thyroid function, pre-eclampsia, diagnostic value

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