摘要
目的探究妊娠期甲状腺功能减退症孕妇血清TSH、FT4水平的检验及与妊娠结局的相关性。方法在2017年6月30日至2019年5月30日来我院进行产检的孕妇中筛选患有甲状腺功能减退症的患者120例,从中随机选择60例患者作为研究组,在孕8w前进行L-T4替代治疗;另随机选择60例患者作为对照组,在孕8w后进行L-T4替代治疗。采用试剂盒检测妊娠期不同阶段TSH、FT4、TT4及TPOAb水平。统计两组患者围生期结局(自然流产、妊娠期高血压疾病、妊娠期糖尿病、胎盘早剥、早产、低出生体重儿及子代6月龄、12月龄的Gesell量表功能区评分)。结果治疗前,两组患者血清中TSH、FT4、TT4及TPOAb水平没有显著性差异(P>0.05),在不同的时间点开始采用相同用药方案,孕30w再次进行检查,两组患者血清中上述生化指标没有显著性差异(P>0.05),研究组患者的自然流产、妊娠期高血压、妊娠期糖尿病、胎盘早剥、低出生体重儿等不良妊娠结局发生例数低于对照组患者,但没有显著性差异(P>0.05),两组患者的子代6月龄、12月龄的Gesell量表评分没有显著性差异,但是对照组患者子代的轻度发育迟缓例数(n=5)与中度发育迟缓例数(n=3)大于研究组患者,差异没有显著性(P>0.05)。结论在妊娠早期对甲状腺功能减退症孕妇及早进行干预,能够有效降低产妇围产期不良结局的发生几率,保证新生儿的早期发育。
Objective:to investigate the serum TSH,FT4 levels in pregnant women with hypothyroidism during pregnancy and their correlation with pregnancy outcome.Methods:120 cases of patients with hypothyroidism were selected from the pregnant women who came to our hospital for prenatal examination on June 30,2017 solstice,May 30,2019,and 60 patients were randomly selected as study group to receive l-t4 replacement therapy before 8 weeks of pregnancy.Another 60 patients were randomly selected as the control group to receive l-t4 replacement therapy after 8 weeks of pregnancy.The levels of TSH,FT4,TT4 and TPOAb in different stages of gestation were detected by the kit.Results:of perinatal outcomes(spontaneous abortion,gestational hypertension,gestational diabetes,placental abruption,preterm delivery,low birth weight,and Gesell scale functional area scores at 6 months and 12 months of age)were analyzed.Results before the treatment,two groups of patients with serum TSH,FT4,TT4 and TPOAb level without significant difference(P>0.05),in different time point,the same regimen at 30 weeks to check again,the biochemical index in serum in both groups have no significant difference(P>0.05),the team in patients with spontaneous abortion,gestational hypertension,gestational diabetes,placental abruption,low birth weight and other adverse pregnancy outcomes were lower than the control group patients,but no significant difference(P>0.05),There was no significant difference in Gesell scale scores between the two groups at the age of 6 months and 12 months,but the number of cases of mild and moderate developmental delay(n=5)and(n=3)in the control group was larger than that in the study group,with no significant difference(P>0.05).Conclusion:early intervention in pregnant women with hypothyroidism in early pregnancy can effectively reduce the incidence of perinatal adverse outcomes and ensure the early development of newborns.
作者
霍金枝
刘南风
佟丽波
邹晓佳
HUO Jin-zhi;LIU Nan-feng;TONG Li-bo;ZOU Xiao-jia(the outpatient department of Obstetrics and Gynecology of 963 Hospital of Chinese people′s Liberation Army joint logistics support force,Heilongjiang Jiamusi 154007;Department of Neonatology,Tongzhou District Maternal and child health care hospital,Tongzhou District,Beijing,101100,Beijing;Obstetrics and Gynecology,the First Affiliated Hospital of Jiamusi University,Heilongjiang,Jiamusi 154007;Obstetrics and Gynecology,Hongda hospital,Jiamusi,Heilongjiang,154007,Heilongjiang)
出处
《中国优生与遗传杂志》
2020年第4期463-466,共4页
Chinese Journal of Birth Health & Heredity
