Objective To analyze the expression levels of thyroid peroxidase antibody(TPO Ab),thyroglobulin antibody(TG Ab),and thyroid stimulating hormone receptor antibody(TR Ab)in the serum of patients with subclinical hy-pothyroidism(hypothyroidism)combined with gestational hypertension(preeclampsia),and their clinical predictive value for pregnancy outcomes.Methods Two hundred and forty-two pregnant women with gestational hypothyroidism who estab-lished fertility records,underwent prenatal examinations,and gave birth at the Northwest Women and Children's Hospital in Xi'an from August 2020 to March 2023 were selected.They were divided into 68 cases of gestational hypothyroidism group and 174 cases of hypothyroidism combined with gestational hypertension group based on whether they were complicated with gestational hypertension.Additionally,242 normal pregnant women of the same period were selected as the normal pregnancy group;Using electrochemiluminescence immunoassay to detect the expression levels of serum TPO Ab,TGAb,and TR Ab;Multivariate logistic regression analysis of the influencing factors of adverse pregnancy outcomes in patients with gestational hypothyroidism combined with hypertension;The predictive value of receiver operating characteristic(ROC)curve analysis of serum TPO Ab,TG Ab,and TR Ab expression levels on pregnancy outcomes in patients with hypothy-roidism combined with preeclampsia.Results The expression levels of serum TPO Ab,TG Ab,and TR Ab increased se-quentially in the normal pregnancy group,gestational hypothyroidism group,and hypothyroidism combined with preeclamp-sia group(F/P=85.036/<0.001,26.675/<0.001,23.086/<0.001).The levels of thyroid stimulating hormone(TSH)in the nor-mal pregnancy group,pregnant hypothyroidism group,and hypothyroidism combined with preeclampsia group increased se-quentially(F/P=85.052/<0.001).Compared with patients with good pregnancy outcomes,patients with poor pregnancy out-comes showed significantly higher levels of systolic blood pressure,diastolic blood pressure,TSH,total cholesterol(TC),tri-glycerides(TG),low-density lipoprotein cholesterol(LDL-C),TPO Ab,TGAb,and TR Ab expression,while high-density lip-oprotein cholesterol(HDL-C)was significantly reduced,the differences were statistically significant(t/P= 3.852/<0.001,2.421/0.017,2.244/0.026,2.342/0.020,2.835/0.005,2.707/0.007,3.475/0.001,3.399/0.001,2.636/0.009,4.280/<0.001).Elevated sys-tolic blood pressure,diastolic blood pressure,TPO Ab,TGAb,TR Ab,TC,and LDL-C are risk factors for adverse pregnan-cy outcomes in patients with gestational hypothyroidism combined with hypertension[OR(95%CI)=3.819(1.376-10.603),3.235(1.198-8.739),5.917(2.341-14.953),9.043(2.924-27.965),1.768(1.252-2.496),2.534(1.085-5.921),4.010(1.559-10.314)].The AUC of serum TPO Ab,TGAb,and TR Ab,as well as their combined prediction of pregnancy outcomes in patients with gestational hypothyroidism combined with hypertension,were 0.723,0.701,0.735,and 0.837,respectively.The combined predictive efficacy of the three was better than their individual predictive efficacy(Z/P=2.317/0.021,2.764/0.006,2.107/0.035).Conclusion The expression levels of TPO Ab,TGAb,and TR Ab in the serum of patients with hypothyroid-ism combined with preeclampsia were significantly increased.The combination of the three has higher value in predicting ad-verse pregnancy outcomes and can be used as a biological indicator for predicting pregnancy outcomes.
维普
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