中文摘要：

目的 探讨血清抗甲状腺过氧化物酶抗体（anti-TPOAb）、25-羟维生素D（25-OH-D）水平与复发性流产（RSA）孕妇临床结局的关系。方法 RSA孕妇603例,促甲状腺素（TSH）及游离甲状腺素4（FT4）均正常,分为anti-TPOAb阳性组301例与anti-TPOAb阴性组302例,对比两组孕早期、孕中期的自然流产情况,以及血清anti-TPOAb、25-OH-D、TSH、FT4水平。结果 anti-TPOAb阳性组的总流产率、早孕期及中孕期流产率均高于anti-TPOAb阴性组（P〈0.05）。在孕早期及孕中期,anti-TPOAb阳性组血清25-OH-D水平均低于anti-TPOAb阴性组（P〈0.05）,anti-TPOAb阳性组自然流产者血清25-OH-D水平均低于未自然流产者（P〈0.05）,且低于anti-TPOAb阴性组自然流产患者（P〈0.05）;在孕早期及孕中期,anti-TPOAb阳性组、阴性组血清TSH、FT4水平比较,差异均无统计学意义（P〉0.05）,anti-TPOAb阳性组、阴性组自然流产者血清TSH、FT4水平比较,差异也均无统计学意义（P〉0.05）;在孕早期及孕中期,anti-TPOAb阳性组、阴性组未自然流产者血清TSH、FT4水平比较,差异均无统计学意义（P〉0.05）。结论 anti-TPOAb阳性RSA孕妇维生素D水平低,自然流产率高于anti-TPOAb阴性孕妇,且这可能与甲状腺功能不足无关。

英文摘要：

Objective To explore the relationship of serum anti-thyroid peroxidase antibody （anti-TPOAb） and 25-hydroxy-vitamin D （25-OH-D） levels with clinical outcome of pregnant women with recurrent spontaneous abortion（RSA）. Methods A total of 603 pregnant women with RSA whose thyroid stimulating hormone （TSH） and free thyroxine 4 （FT4 ） were normal were divided into positive anti-TPOAb group （ n = 301 ） and negative anti-TPOAb group （ n = 302 ）. The incidence rate of spontaneous abortion, the levels of serum anti-TPOAb, 25-OH-D,TSH and FT4 were compared between the two groups during the first and second trimester of pregnancy. Results The positive anti-TPOAb group had higher total incidence rate of abortion,and higher incidence rates of abortion during the first and second trimester of pregnancy compared to the negative anti-TPOAb group （ P 〈 0.05 ）. During either the first or second trimester of pregnancy, the serum 25-OH-D level in the positive anti-TPOAb group was lower than that in the negative anti-TPOAb group （P 〈 0.05 ）, and the level of pregnant women with spontaneous abortion in the positive anti-TPOAb group was lower than that of pregnant women without spontaneous abortion in the positive anti-TPOAb group or pregnant women with spontaneous abortion in the negative anti-TPOAb group （ P 〈 0.05 ）. During either the first or second trimester of pregnancy, there was no statistical difference in serum TSH level or FT4 level between the positive and negative anti-TPOAb groups（P 〉0.05 ）, and no statistical difference in serum TSH level or FT4 level was found between the pregnant women with spontaneous abortion in the positive anti-TPOAb group and negative anti-TPOAb group（ P 〉 0.05 ）. During either the first or second trimester of pregnancy,there was no statistical difference in serum TSH level or FT4 level between the pregnant women without spontaneous abortion in the positive anti-TPOAb group and negative anti-TPOAb group （P 〉 0.05）. Conclusion The vita