不同阶段妊娠期甲状腺功能亢进症患者的甲状腺功能变化被引量：16

Thyroid function change of patients with hyperthyroidism during different gestational stages

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摘要目的探析甲状腺功能变化在妊娠期甲状腺功能亢进症(甲亢)患者中的临床价值。方法分析在医院接受治疗的86例妊娠期甲亢患者的临床资料,根据妊娠不同阶段将入选者分成A组(妊娠早期甲亢患者)25例、B组(妊娠中期甲亢患者)27例、C组(妊娠晚期甲亢患者)34例;另选取同期在本医院接受治疗的38例非妊娠期甲亢患者作为对照组,比较A、B、C组与对照组甲状腺功能的变化情况。结果 A组的TRAb阳性率明显低于对照组,而TT_3和TT_4水平明显高于对照组(P<0.05),但是两组的FT_3、FT_4以及HS-TSH水平差异无统计学意义(P>0.05)。B组患者的TT_3、TT_4水平明显高于对照组(P<0.05),但两组间TRAb阳性率、FT_3、FT_4以及HS-TSH水平差异无统计学意义(P>0.05)。C组患者的TT_3、TT_4水平明显高于对照组、而FT_3、FT_4水平明显低于对照组(P<0.05),两组间TRAb阳性率、HS-TSH水平差异无统计学意义(P>0.05)。结论妊娠期甲亢患者可以通过TRAb、FT_3、FT_4水平的变化进行早期确诊、病情监测及用药指导。 Objective To explore the clinical value of thyroid function change in patients with hyperthyroidism during different gestational stages. Methods The clinical data of 86 patients with hyperthyroidism in pregnancy treated in the hospital was retrospectively analyzed,then the patients were divided into group A（25 cases with hyperthyroidism during early pregnancy）,group B（27 cases with hyperthyroidism during middle pregnancy）,and group C（34 cases with hyperthyroidism during late pregnancy）. Thirty- eight unpregnant women with hyperthyroidism treated in the hospital during the same period were chosen as control group. The changes of thyroid function of patients in group A,group B,group C and control group were compared. Results The positive rate of TRAb in group A was statistically significantly lower than that in control group,while the levels of TT3 and TT4 in group A were statistically significantly higher than those in control group（ P〈0. 05）,but there was no statistically significant difference in the levels of FT3,FT4,and high-sensitive thyroid-stimulating hormone（ HS-TSH） between the two groups（ P〉0. 05）. The levels of TT3 and TT4 in group B were statistically significantly higher than those in control group（ P〈0. 05）,but there was no statistically significant difference in the positive rate of TRAb and levels of FT3,FT4,HS-TSH between the two groups（ P〈0. 05）. The levels of TT3 and TT4 in group C were statistically significantly higher than those in control group,while the levels of FT3 and FT4 were statistically significantly lower than those in control group（ P〈0. 05）,there was no statistically significant difference in the positive rate of TRAb and HS-TSH level between the two groups（ P〈0. 05）. Conclusion Detection of the levels changes of TRAb,FT3,FT4 for patients with hyperthyroidism in pregnancy can help early diagnosis and disease monitoring,and guide drug uses.

作者张红卫周琳乔丽

机构地区淄博市第一医院妇科

出处《中国妇幼保健》 CAS 2016年第9期1819-1821,共3页 Maternal and Child Health Care of China

关键词甲状腺功能妊娠甲状腺功能亢进症临床价值 Thyroid function Pregnancy Hyperthyroidism Clinical value

分类号 R714.256 [医药卫生—妇产科学]

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参考文献14

1Rajput R,Goel V,Nanda S,et al.Prevalence of thyroid dysfunction among women during the first trimester of pregnancy at a tertiary care hospital in Haryana[J].Indian J Endocrinol Metab,2015,19(3):416-419.
2宋志慧,季淑英,张晓欲.妊娠剧吐妇女hCG与一过性甲亢的关系及临床治疗[J].中国妇幼保健,2013,28(13):2042-2043. 被引量：12
3张淼,时立新.2012年中国《妊娠和产后甲状腺疾病诊治指南》解读[J].中国实用内科杂志,2012,32(10):761-763. 被引量：35
4Skweres T,Wojcik D,Ciepluch R,et al.Thyroid dysfunction during severe ovarian hyperstimulation syndrome.A case report[J].Ginekol Pol,2014,85(6):472-475.
5Shikha D,Singla M,Bajracharya B,et al.A Case of Gestational Thyrotoxicosis Associated with Wernicke's Encephalopathy[J].Endocr Pract,2014,20(12):e237-e240.
6Tumian NR,Wong M,Wong CL.alpha-thalassemia-associated hydrops fetalis:a rare cause of thyrotoxic cardiomyopathy[J].J Obstet Gynaecol Res,2015,41(6):967-970.
7王少为,赵晓东.重视妊娠合并甲状腺疾病[J].中华妇产科杂志,2014,49(11):807-810. 被引量：15
8Speer G.The impact of thyroid function in women of reproductive age:infertility,pregnancy and the postpartum period[J].Orv Hetil,2013,154(51):2017-2023.
9Abbouda A,Trimboli P,Bruscolini A.A mild Grave's ophthalmopathy during pregnancy[J].Semin Ophthalmol,2014,29(1):8-10.
10Ahmad S,Geraci SA,Koch CA.Thyroid disease in pregnancy:(Women's Health Series)[J].South Med J,2013,106(9):532-538.

二级参考文献16

1关海霞,李晨阳,李玉姝,范晨玲,滕颖,欧阳煜宏,丛琦,滕卫平.妊娠晚期妇女甲状腺疾病特点及甲状腺自身抗体变化的研究[J].中华妇产科杂志,2006,41(8):529-532. 被引量：39
2陈祖培.尿碘的测定及其临床意义[J].中国地方病学杂志,1997,16(1):35-37. 被引量：169
3杨慧霞主译.妊娠合并症[M].北京:人民卫生出版社,2006:21-26.
4ATA. Guideline of ATA for the diagnosis and management of thyroid diseases during pregnancy and postpartum [ J 1. Thyroid, 2011,21 (10) :1081 - 1125.
5Baloch Z, Carayon P, Conte-Devolx B, et al. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monito- ring of thyroid dlsease[J]. Thyroid,2003,13( 1 ) :3 - 126.
6Lazarus JH, Bestwick JP, Channon S, et al. Antenatal thyroid screen- ing and childhood cognitive function [ J ]. N Engl J Med, 2012,366 (6) :493 -501.
7Stricker R,Echenard M,Eberhart R,et al.Evaluation of maternal thyroid function during Pregnancy:the importance age-specific reference intervals[J].Eur J Endocrinol,2007,157(4):509-514.
8WHO Technical Consultation:Lodine requirements in Pregnancy and infancy[J].IDD Newsletter,2007,23(1):1-2.
9Pekonen F,Alfthan H,Stenman UH,et al,Human chorionic gonadotropinc(h CG)and thyroid function in early human prognancy,circadian variation and evidence for intrinsic thyrotropic activity of h CG[J].J Clin Engocrinol Metab,1998,66(4):853-856.
10Shields BM,Knight BA,Hill AV,et al.Five-year followu P for women with subclinical hypothyroidism in pregnancy[J].J Clin Endocrinol Metab,2013,98(12):E1941-E1945.