摘要
目的探讨妊娠合并甲亢对母婴代谢指标和预后的影响。方法选取2011年5月-2016年1月该院收治的妊娠合并甲亢孕妇52例,经系统治疗后分娩前甲状腺功能基本恢复正常者34例(疾病控制组),未经系统治疗或经短暂治疗后中途停药者18例(未控制组);另选取同期在该院进行孕检及分娩的甲状腺功能正常孕妇50例(正常对照组)。分娩前,采用酶联免疫吸附法(ELISA)检测甲状腺激素含量;采用放射免疫法检测糖代谢指标水平,计算胰岛素抵抗指数(HOMA-IR)及胰岛素敏感指数(ISI);采用全自动生化分析仪检测脂质代谢指标含量;随访并记录3组孕妇及新生儿的分娩结局。结果未控制组孕妇的血清游离三碘甲腺原氨酸(FT_3)、游离甲状腺素(FT_4)含量高于疾病控制组、正常对照组,促甲状腺激素(TSH)含量低于疾病控制组(P<0.05);外周血空腹血糖(FPG)、空腹胰岛素(FINS)、HOMA-IR及ISI绝对值水平均高于疾病控制组、正常对照组(P<0.05);外周血总胆固醇(TC)、甘油三酯(TG)含量高于疾病控制组、正常对照组,高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A-Ⅰ(ApoA-Ⅰ)含量低于疾病控制组、正常对照组(P<0.05);母体结局中流产引产率高于疾病控制组、正常对照组,新生儿结局中死胎、低出生体重、新生儿甲亢发生率高于疾病控制组、正常对照组(P<0.05)。结论妊娠合并甲亢可导致孕妇糖代谢及脂质代谢异常,病情未经控制者母体及新生儿预后不佳。
Objective To explore the effect of pregnancy combined with hyperthyroidism on maternal and infantile metabolic indexes and prognosis. Methods Fifty-two pregnant women with hyperthyroidism treated in the hospital from May 2011 to January 2016 were selected,after systemic treatment,thyroid function returned to normal before delivery in 34 pregnant women（ disease control group）,the other 18 pregnant women were designed as uncontrolled group（ without systemic treatment or giving up durg therapy after short-term treatment）.Fifty pregnant women with normal thyroid function receving prenatal examiantion and giving birth to their babies in the hospital during the same period were selected as normal control group. Before delivery,ELISA was used to detect the levels of thyroid hormones; radioimmunoassay was used to detect the levels of glucose metabolism indexes,HOMA-IR and insulin sensitivity index（ ISI） were calculated. Fully automatic biochemical analyser was used to detect the levels of lipid metabolism indexes. Pregnancy and neonatal outcomes in the three groups were followed up and recorded. Results The levels of serum free triiodothyronine（ FT3） and free thyroxine（ FT4） in uncontrolled group were statistically significantly higher than those in disease control group and normal control group（ P〈0. 05）. The level of thyroid stimulating hormone（ TSH） in uncontrolled group was statistically significantly lower than those in disease control group（ P〈0. 05）. The levels of fasting blood glucose（ FPG）,fasting insulin（ FINS）,insulin resistance index（ HOMA-IR）,and insulin sensitivity index（ ISI） in uncontrolled group were statistically significantly higher than those in disease control group and normal control group（ P〈0. 05）. The levels of total cholesterol（ TC） and triglyceride（ TG） in peripheral blood in uncontrolled group were statistically significantly higher than those in disease control group and normal control group（ P〈0. 05）. The levels of high density lipoprotein cholesterol（ HDL-C） and apolipoprotein A-Ⅰ（ ApoA-Ⅰ） in uncontrolled group were statistically significantly lower than those in disease control group and normal control group（ P〈0. 05）. The incidence rate of abortion in uncontrolled group was statistically significantly higher than those in disease control group and normal control group（ P〈0. 05）. The incidence rates of stillbirth,low birth weight,neonatal hyperthyroidism in uncontrolled group were statistically significantly higher than those in disease control group and normal control group（ P〈0. 05）. Conclusion Pregnancy complicated with hyperthyroidism can lead to abnormal glucose metabolism and lipid metabolism of pregnant women,the prognosis of uncontrolled mothers and neonates is poor.
出处
《中国妇幼保健》
CAS
2017年第12期2605-2608,共4页
Maternal and Child Health Care of China
关键词
妊娠合并甲亢
糖代谢
脂质代谢
妊娠结局
Pregnancy combined with hyperthyroidism
Glucose metabolism
Lipid metabolism
Pregnancy outcome
