摘要
目的探讨妊娠合并甲状腺功能减退(甲减)对妊娠结局及胎儿的影响。方法选取2010年1月至2014年1月宝鸡市人民医院妇产科收治的115例妊娠合并甲减孕妇作为研究对象,经治疗后51例患者甲状腺功能恢复正常(观察组),64例患者甲状腺功能仍未达正常指标(对照组)。比较不同孕期孕妇的促甲状腺激素(TSH)水平和甲状腺激素需求量,同时记录两组患者的妊娠结局、胎儿情况及并发症发生率。结果孕中期、孕晚期TSH水平较孕早期显著升高(P<0.05),产后TSH水平显著下降(P<0.05);孕中期、孕晚期对甲状腺素需求量较孕前显著提高(P<0.05);观察组患者妊娠高血压、胎儿宫内窘迫、糖代谢异常和妊娠肝内胆汁淤积症的发生率显著低于对照组(P<0.05);观察组患者早产、新生儿窒息、胎儿畸形和死胎的发生率显著低于对照组(P<0.05)。结论妊娠合并甲减孕妇应定期监测甲状腺功能,在妊娠期间要调整甲状腺激素的用药剂量,可有效降低并发症发生率,改善妊娠结局。
Objective To explore the influence of maternal hypothyroidism on the neonatal and preg- nancy outcome. Methods A total of 115 cases of maternal hypothyroidism admitted to Baoji City People＇s Hospital from Jan. 2010 to Jan. 2014 were included as research objects. After treatment,51 cases returned to a euthyroid state（ observation group） and 64 cases didn＇t return to normal（ control group ）. The thyroid stim- ulating hormone（TSH） level and thyroxine dose requirement of the two groups were analyzed. The neonatal, pregnancy outcome and complication of the two groups were recorded. Results Compared with early preg- nancy ,the TSH level of middle and late pregnancy were significantly increased（ p 〈 0.05 ） and the TSH level Were significantly decreased after childbirth （ P 〈 0.05 ）. Compared with pregestation, the thyroxine dose requirement of middle and late pregnancy were significantly increased （ P 〈 0.05 ）. The complication （ gesta- tional hypertension, fetal distress, abnormal glucose metabolism and intrahepatic cholestasis of pregnancy） rates of the observation group were significantly lower than the control group（ P 〈 0.05 ）, and the pregnancy outcome（ preterm birth, neonatal asphyxia, fetal malformation and stillbirth） of the observation group were better than the control group （ P 〈 0.05 ）. Condusion Thyroxine dose requirement increases during preg- nancy and close monitoring of thyroid function with appropriate adjustment of thyroxine dose should be done, which can reduce complication of pregnancy and improve the pregnancy outcome.
出处
《医学综述》
2015年第20期3818-3819,共2页
Medical Recapitulate
关键词
妊娠
甲状腺功能减退
妊娠结局
胎儿
Pregnancy. Hwothvroidism： Pretmancv outcome ： Neonatal
