摘要
目的探讨甲状腺疾病筛查以及干预对孕妇妊娠结局的影响。方法选取2012年9月-2014年8月广东省深圳市龙华新区人民医院内分泌科和产科就诊的2490例孕妇,对其进行甲状腺功能和甲状腺抗体筛查,将患有甲状腺疾病的孕妇分为治疗组（192例）和未治疗组（192例）,余2124例无甲状腺疾病的孕妇设为正常组。未治疗组不予任何干预治疗,治疗组按照孕妇的筛查结果给予相应的治疗。观察统计孕妇在不同妊娠期（妊娠时间〈13周为T1期,13-〈28周为T2期,≥28周为T3期）甲状腺激素和甲状腺过氧化物酶抗体（TPo Ab）的水平。比较两组孕妇不良妊娠结局和产科并发症的发生情况。结果 2490例孕妇中,甲状腺疾病总患病率为15.42%,其中临床甲减者占1.91%,亚临床甲减者占6.75%,临床甲亢者占0.24%,亚临床甲亢者占0.96%,低甲状腺素血症者占2.91%,甲状腺功能正常TPo Ab阳性者占2.65%。对甲状腺功能正常孕妇进行随访,检测血清发现：随着孕龄的增加,血清FT3、FT4水平不断下降,血清FT3、FT4、TSH水平T1与T3期比较、T2与T3期比较,差异均有统计学意义（均P〈0.05）。未治疗组中,甲状腺功能正常TPo Ab阳性及亚临床甲减孕妇所分娩的新生儿出生5 min后Apgar评分均明显低于正常组,差异均有统计学意义（P〈0.05）;各种甲状腺疾病孕妇的不良妊娠结局和产科并发症总患病率均高于正常组,差异均有统计学意义（P〈0.05）。治疗组中,所有患有甲状腺疾病的孕妇经过相应的治疗后,不良妊娠结局和产科并发症总患病率与正常组比较,差异均无统计学意义（P〉0.05）。结论及时筛查妊娠期甲状腺疾病并根据具体筛查结果积极进行相应的干预治疗可明显改善妊娠结局。
Objective To investigate thyroid disease screening and intervention effects on pregnancy outcome of pregnant women. Methods 2490 cases of pregnant women from September 2012 to August 2014 in endocrinology department and obstetrical department of the People＇s Hospital of Longhua New District in Shenzhen City were selected, and they were given thyroid function and thyroid antibody screening. They were divided into treatment group（192 cases）and non-treatment group（192 cases）. 2124 pregnant women without thyroid disease as the normal group. Pregnant women of the treatment group without any intervention, while pregnant women of the treatment group were given the appropriate treatment in accordance with their screening results. the statistics and observation of all pregnant women in different gestational（〈13 weeks of gestation or less was T1phase; 13-〈28 weeks of pregnancy was T2stage; ≥ 28 weeks was the T3stage） thyroid hormones and thyroid peroxidase antibody levels were carried; and the adverse pregnancy outcomes and obstetric complications of two groups were compared. Results In 2490 cases, thyroid disease, the total prevalence rate was 15.42%, of which 1.91% with clinical hypothyroidism, 6.75% with subclinical hypothyroidism,clinical hyperthyroidism and subclinical hyperthyroidism was 0.24%, 0.96% respectively, 2.91% of hypothyroxinemia,thyroid function was normal but TPo Ab positive was 2.65%. Follow-up on thyroid function of normal pregnant women,the detection of serum showed that： with the increase of gestational weeks, serum FT3, FT4 levels continue to decline,while TSH showed a rising trend, compared the serum FT3, FT4 and TSH level between T1 and T3stage, T2 and T3stage, the differences were statistically significant（all P〈0.05）. In non-treatment group, Apgar score 5 min of newborns after delivered of pregnant women with thyroid function and TPo Ab positive, and subclinical hypothyroidism were significantly lower than the normal group, the differences were statistically significant（P〈0.05）; adverse pregnancy outcomes, the total prevalence rate of obstetric complications of pregnant women with various thyroid diseases were higher than that in the normal group, the differences were statistically significant（P〈0.05）. In the treatment group, adverse pregnancy outcomes and total prevalence of obstetric complications of all pregnant women with thyroid disease after corresponding treatment had no statistically significant differences compared with the normal group（P〉0.05）. Conclusion Timely screening for gestational thyroid disease and actively intervene therapy according to the corresponding specific screening results can significantly improve the outcome of pregnancy.
出处
《中国医药导报》
CAS
2015年第23期71-74,共4页
China Medical Herald
基金
广东省深圳市龙华新区社会公益科研项目(2013056)
关键词
妊娠期
甲状腺疾病
妊娠结局
干预治疗
Pregnancy
Thyroid disease
Pregnancy outcome
Intervention therapy
