目的：测定不同孕期孕妇甲状腺激素以及抗甲状腺过氧化物酶抗体（ TPOAb ）的水平，并探讨两者的关系。方法常规检查的孕妇400例，用全自动生化仪对其促甲状腺激素（ TSH）、游离甲状腺激素（ FT4）、总甲状腺素（ TT4）以及TPOAb的水平进行检测。结果甲状腺功能正常的孕妇及TPOAb阴性的孕妇中，妊娠早期、中期、晚期TSH水平不同（ P＜0．05）；TPOAb阴性的孕妇组早期、中期、晚期的TSH的中位数显著低于TPOAb阳性组（ P＜0．05）；与采用血清FT4为诊断标准比较，采用TT4水平进行诊断，临床甲状腺功能减退症的检出率较低（P＜0．05），而亚临床甲状腺功能减退症的检出率则无明显差异（P＞0．05）。结论在筛查时，应重视TPOAb阳性的孕妇，并且注意FT4与TT4在诊断上的差异。%Objective To detect the levels of thyroid hormone and thyroid peroxidase antibody ( TPOAb ) of pregnant women in different trimesters ,and to explore the relationship between them .Methods Four hundred pregnant women underwent routine examination were detected for the levels of thyroid -stimulating hormone ( TSH) ,free thyroxine (FT4),total thyroxine(TT4) and TPOAb by using automatic biochemical analyzer .Results The TSH levels of pregnant women with normal thyroid function or with negative TPOAb showed significant differences among early ,middle and late trimesters(P<0.05).The median TSH of pregnant women with negative TPOAb was significantly lower than that of pregnant women with positive TPOAb in early ,middle and late trimesters ( P<0 .05 ) .Using TT4 level as a diagnostic criteria,the detection rate of hypothyroidism was lower in contrast with those diagnosed by using serum FT 4 level as the criteria(P<0.05),but the detection rate of subclinical hypothyroidism showed no significant difference (P <0.05). Conclusion We should pay attention to pregnant women with positive TPOAb as well as the difference in the diagnosis between FT4 and TT4 when conducting a screening in pregnant women .
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