ABSTRACT
OBJECTIVE: To investigate the pregnancy outcome and pregnancy complications in patients with subclinical hypothyroidism with negative anti-thyroid peroxidase(TPO-Ab)in early pregnancy.METHODS:From January 2016 to February 2018,4,616 cases of early-gestation pregnant women in Shanghai Tinglin Hospital were selected.According to the age,the patients were divided into groups of 18-24 years old(602 cases),25-29 years old(2604 cases),30-34 years old(1330 cases),and over 35 years old(80 cases).Subclinical incidence of TPO-Ab-negative hypothyroidism in pregnant women of different age groups was compared.According to whether TPO-Ab-negative subclinical hypothyroidism patients received LT4 replacement therapy, they were divided into treatment group(receiving treatment,160 cases)and observation group(not receiving treatment,98 cases),and 526 normal pregnant women in the same period were included as the control group.The incidence of various pregnancy complications and pregnancy outcomes and their statistical significance were compared among the three groups.RESULTS:Comparison of the incidence of TPO-Abnegative subclinical hypothyroidism:the age group of 30-34 years old(7.97%)was higher than the age group of 25-29 years old(5.99%)and the age group of 18-24 years old(3.99%);the age group of over 35 years old(12.50%)was higher than the age group of 25-29(5.99%)and the age group of 18-24(3.99%);the age of over 35 years old(12.50%)was higher than the age group of 25-29(5.99%)and the age group of 18-24(3.99%),and the differences were statistically significant(P<0.05).The incidence of gestational diabetes was higher in the observation group(14.29%)than in the treatment group(6.25%)and the control group(4.94%),and the incidence of anemia in the observation group(44.90%)was higher than that in the treatment group(30.00%)and the normal control group(26.04%).The neonatal birth weight of the treatment group(3200±300 g)and the control group(3150±statistical significance(P<0.05).CONCLUSION:The incidence of TPO-Ab-negative subclinical hypothyroidism in early pregnancy increases with age.Timely intervention should be given to reduce the occurrence of gestational anemia diabetes,which is conducive to the growth and development of offsprings.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effect of cytomegalovirus (CMV) infection following kidney transplantation on long-term renal function and its mechanism.</p><p><b>METHODS</b>Ninety-six patients undergoing kidney transplantation between March 2000 and December 2005, who completed a 3-year follow-up investigation, were divided into 3 groups according CMV-pp65 antigenemia and clinical symptoms. Group A consisted of 33 recipients with symptomatic active CMV infection, group B included 33 with asymptomatic active CMV infection and group C included 30 with inactive infection. The relation of CMV infection, transforming growth factor-beta1 (TGF-beta1) mRNA in the peripheral blood mononuclear cells (PBMCs) and serum creatinine (Scr) were analyzed, and the grafts in 6 cases with renal dysfunction were biopsied.</p><p><b>RESULTS</b>The expression of TGF-beta1 mRNA in PBMCs was significantly higher in group A than in the other two groups 6 months after the transplantation (P<0.01), while Scr levels showed no significant difference between the 3 groups (P>0.05). Three years later, Scr levels in group A were significantly increased as compared with those in the other two groups (P<0.01), and the rate of renal dysfunction in group A (10/33) was significantly higher than those in group B (3/33) and C(3/30) (P<0.05). In the 16 with renal dysfunction, the expression of TGF-beta1 mRNA in PBMCs significantly higher than that in the other 80 patients with normal renal function (P<0.01). Renal allograft biopsies demonstrated mild or severe interstitial fibrosis, tubular atrophy and mononuclear cell infiltration in the 6 patients with renal graft dysfunction, supporting the diagnosis of chronic allograft nephropathy (CAN).</p><p><b>CONCLUSION</b>Symptomatic active CMV infection in renal allograft recipients is an important factor contributing to the occurrence of CAN. Monitoring of TGF-beta1 mRNA expression in PBMCs proves useful in identifying patients at risk of CAN.</p>