摘要
目的 探讨孕中期亚临床甲减孕妇并发妊娠糖尿病的发生率及糖代谢的变化,并分析其临床特点。方法 选取2010年1月至2013年11月在唐山市妇幼保健院诊断为亚临床甲减（SCH）的孕妇635例。对SCH孕妇给予左旋甲状腺激素（L-T4）治疗,治疗目标为TSH 0.3~2.5 m IU/L,按治疗效果分为治疗达标组401例,治疗未达标组234例。另选择同期正常孕妇300例作为对照组。在孕中期（24~28周）进行甲状腺功能（TSH、FT4、FT3）检测及75g葡萄糖耐量试验（OGTT）,比较各组妊娠期糖尿病（GDM）的发病率及OGTT结果。结果 治疗未达标组GDM的发生率明显高于治疗达标组和对照组,差异有统计学意义（χ2=17.22,15.04,P〈0.05）;治疗未达标组OGTT空腹和1h血糖值明显低于治疗达标组和对照组,差异有统计学意义（P值均〈0.05）。结论 未积极治疗或治疗未达标的SCH孕妇较正常孕妇更容易发生GDM,甲状腺激素的补充治疗有助于降低SCH孕妇的GDM发病率。
Objective To investigate the changes of glucose metabolism and an attack rate of pregnant women with subclinical hypothyroid complicated with gcstational diabetes mellitus （GDM）. Methods 300 cases of normal pregnant women Were selected as the control group and 635 cases of pregnant women with subclinical hypothyroid complicated with gestational diabetes mellitus were enrolled as observation group. The observation group was divided into standard group （401 cases） and non-standard group （234 cases） based on the left-handed thyroid hormone （L-T4 ） treatment effect. The serum levels of TSH, FT4 and FT3 and 75 g of glucose tolerance test （OGTT） in all patients were deteeted. Results The incidence of GDM in the treatment of non-standard group was obviously higher than that of the treatment of standard group and control group （χ2 = 17.22,15.04,P 〈 0.05）. The fasting blood glucose and blood glucose at 1 hour in non-standard group were significantly lower than that of standard group and control group （P 〈 0.05 ）. Conclusion The patients without treatment and no treatment effeets are more easily to have the GDM than the healthy controls. Thyroid hormone replacement therapy could be helpful to reduce the ineidenee of subclinical hypothyroidism complieated with gestational diabetes mellitus.
出处
《标记免疫分析与临床》
CAS
2015年第9期906-908,共3页
Labeled Immunoassays and Clinical Medicine
关键词
妊娠期糖尿病
亚临床甲减
促甲状腺素
糖耐量试验
Gestational diabetes mellitus
Subclinical hypothyroidism
Thyroid stimulating hormone
Glucose tolerance test
