Clinical significance of serum levels of thyroid stimulating hormone receptor antibody in pregnant women with Graves' disease

作     者：赵志英 田健 朱立 Zhao Zhi-ying Tian Jian Zhu Li Department of Nuclear Medicine,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China

作者机构：Department of Nuclear MedicinePeking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical Sciences 

出 版 物：《生殖医学杂志》 (Journal of Reproductive Medicine)

年 卷 期：2010年第19卷第A2期

页      面：49-53页

学科分类：0710[理学-生物学] 071010[理学-生物化学与分子生物学] 090602[农学-预防兽医学] 081704[工学-应用化学] 07[理学] 08[工学] 0817[工学-化学工程与技术] 09[农学] 0906[农学-兽医学] 

主　　题：甲状腺激素受体 抗体血清 临床意义 孕妇 甲状腺功能 化学发光免疫分析 功能障碍 新生儿 

摘      要：Objective:To investigate the clinical significance of serum thyroid stimulating hormone(TSH) receptor antibody (TRAb) levels and the antithyroid drug(ATDs) use in pregnant women with Graves disease in their neonatal thyroid function. Methods:The serum TRAb and T3,T4,FT3,FT4,TSH levels in 68 pregnant women with Graves disease and their newborns were detected by radio receptor assay(RRA) and electrical chemiluminescence immunoassay (ECLIA),*** on the maternal serum TRAb levels and the use of antithyroid drugs during pregancy, the newborns were divided into different *** incidence of neonatal thyroid dysfunction and its risk factors were analyzed. Results:The results showed the incidence of abnormal thyroid function of newborns was 29.4%(20/68).The proportion of neonatal thyroid dysfunction in women with high TRAb levels in the third trimester of pregnancy were significantly higher than these with normal TRAb(P0.01).In 23 newborns whose mothers were normal in serum TRAb levels and took no ATDs during pregnancy,only one case had thyroid dysfunction within two weeks after birth,while in other 45 newborns whose mothers had a high level of serum TRAb and/or took ATDs during pregnancy, 19 developed thyroid dysfunction within two weeks after birth. Conclusion:Neonatal thyroid function depends on the balance between the transplacental TRAb and ATDs. TRAb measurement in pregnant women with Graves disease is of significance in evaluation of neonatal thyroid function. Elevated level of serum TRAb in the third trimester of pregnancy is a risk factor for neonatal thyroid dysfunction.