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目的研究抗甲状腺抗体(ATA)与复发性流产(RSA)之间的关系,初步探讨泼尼松对于ATA相关RSA的临床疗效。方法分别检测有RSA史非妊娠妇女120例(研究组),有正常妊娠史非妊娠健康妇女115例(对照组)及有ATA相关RSA史妊娠患者38例(治疗组)和未用激素治疗30例(未治疗组)的ATA水平[包括抗甲状腺过氧化物酶抗体(TPO-Ab)、抗甲状腺球蛋白抗体(TG-Ab)];治疗组妊娠前后给予中小剂量泼尼松治疗,并比较治疗前后的ATA水平,随访两组妊娠结局,比较两组间的活产率。结果研究组血清中ATA阳性率、TPO-Ab阳性率明显高于对照组(均P<0.05),TG-Ab阳性率虽高于对照组,但差异无统计学意义(P>0.05);治疗组治疗后ATA水平明显低于治疗前(P<0.05);治疗组活产率为65.79%,未治疗组为33.33%,差异有统计学意义(P<0.05)。结论ATA与RSA有关,尤其与TPO-Ab关系密切;中小剂量泼尼松能有效降低ATA水平,提高ATA相关的RSA患者的妊娠成功率,值得临床推广应用。
Objective To investigate the relationship between anti-thyroid antibody (ATA) and recurrent spontaneous abortion (RSA) and to explore the clinical efficacy of prednisone in ATA-related RSA. Methods A total of 120 non-pregnant women with RSA (study group), 115 non-pregnant healthy women with normal pregnancy history (control group) and 38 pregnant women with ATA-associated RSA history (treatment group) and 30 ATA levels (including anti-thyroid peroxidase antibody (TPO-Ab) and anti-thyroglobulin antibody (TG-Ab)] in the untreated (untreated) group were compared with those in the untreated group Before and after treatment of ATA levels, followed up two groups of pregnancy outcomes, compared with the live birth rate between the two groups. Results The serum ATA positive rate and TPO-Ab positive rate in the study group were significantly higher than those in the control group (all P <0.05). The positive rate of TG-Ab was higher than that in the control group, but the difference was not statistically significant (P> 0.05) The level of ATA in the treatment group was significantly lower than that before treatment (P <0.05). The live birth rate was 65.79% in the treatment group and 33.33% in the untreated group. The difference was statistically significant (P <0.05). Conclusions ATA is related to RSA, especially TPO-Ab. Small and medium-dose prednisone can effectively reduce the level of ATA and improve the pregnancy success rate in ATA-related RSA patients, which is worthy of clinical application.