目的 比较细胞因子TGF-β、IL-10、TNF-α、Th17在不同妊娠结局的妊娠期亚临床甲减孕妇血清中的差异,探索细胞因子在不同妊娠结局中的作用。方法 随机选择2018年1月—2018年12月在我院就诊的66例确诊为因妊娠期亚临床甲减而出现不良妊娠结局的孕妇与同期妊娠结局正常的66例孕妇进行病例对照研究,比较不同妊娠结局孕妇的血清TGF-β、IL-10、TNF-α、Th17的差异;结果 ① 亚临床甲减组的TPOAb、TgAb、TRAb阳性率高于正常妊娠组,同时TNF-α、Th17均高于正常妊娠组,而TGF-β、IL-10均低于正常妊娠组,差异有统计学意义(P<0.05)。② 因子分析发现:在TPOAb、TgAb、TRAb、TGF-β、IL-10、TNF-α、Th17七个影响妊娠期亚临床甲减不良妊娠结局的相关因素中,TGF-β、IL-10、TNF-α、Th17在第1影响因子,特征值达2.347;TPOAb、TgAb、TRAb是次要影响因子,特征值为1.162。结论 TGF-β、IL-10、TNF-α、Th17与妊娠期亚临床甲状腺功能减退症的不良妊娠结局有密切关系,TGF-β、IL-10、TNF-α、Th17是影响妊娠期亚临床甲减不良妊娠结局的主要因子;TPOAb、TgAb、TRAb是影响妊娠期亚临床甲减不良妊娠结局的次要因子。

Objective To compare the serum levels of TGF-β, IL-10, TNF-α and Th17 in pregnant women with subclinical hypothyroidism in different pregnancy outcomes. Methods A case-control study was conducted in 66 pregnant women with adverse pregnancy outcomes due to subclinical hypothyroidism during pregnancy and 66 pregnant women with normal pregnancy outcomes during the same period. The differences of serum TGF-β, IL-10, TNF-α and Th17 among pregnant women with different pregnancy outcomes were compared. Results ①The positive rates of TPOAb, TgAb and TRAb in subclinical hypothyroidism group were higher than those in normal pregnancy group, and TNF-α and Th17 were higher than those in normal pregnancy group, while TGF-βand IL-10 were lower than those in normal pregnancy group (P<0.05). ②Factor analysis found that TPOAb, TgAb, TRAb, TGF-β, IL-10, TNF-α and Th17 were the factors related to adverse pregnancy outcomes of subclinical hypothyroidism in pregnancy. TGF-β, IL-10, TNF-α and Th17 were the main influencing factors with a characteristic value of 2.347; TPOAb, TgAb and TRAb were the second influencing factors,with a characteristic value of 1.162. Conclusion ①TGF-β, IL-10, TNF-α, Th17 are closely related to the occurrence and pregnancy outcome of subclinical hypothyroidism in pregnancy. ②TGF-β, IL-10, TNF-α and Th17 are the main factors affecting the adverse pregnancy outcomes of subclinical hypothyroidism in pregnancy;TPOAb, TgAb and TRAb are the secondary factors affecting the adverse pregnancy outcomes of subclinical hypothyroidism in pregnancy,