摘要
目的:观察左旋甲状腺激素(L-T 4)治疗甲状腺过氧化物酶(TPOAb)阴性的妊娠合并亚临床甲状腺功能减退症(SCH)对妊娠结局的影响。方法:回顾分析2018年1月至2019年1月在广东省妇幼保健院行妊娠早期甲状腺激素筛查且有妊娠结局记录的867例孕产妇的临床资料。867例孕产妇中,甲状腺功能正常(N)+TPOAb(-)者584例(对照组),SCH+TPOAb(-)者283例,其中112例未接受左旋甲状腺治疗(观察组),171例接受左旋甲状腺素治疗(治疗组)。比较3组孕妇的妊娠结局及产科并发症情况。结果:观察组孕妇的流产率、妊娠期糖尿病发生率、早产率、出生低体质量儿发生率高于对照组、治疗组,差异均有统计学意义( P <0.05)。观察组中3.4%最终发展为临床甲减。结论:妊娠早期合并SCH患者,TPOAb阴性者亦应及时给予L-T 4治疗;L-T 4治疗能有效改善妊娠合并TPOAb阴性的L-T 4患者不良妊娠结局。
Objective: To observe Levothyroxine (L-T 4) treatment for Thyroid peroxidase antibody (TPOAb) negative pregnancy with subclinical hypothyroidism (SCH) on the influence of pregnancy outcomes. Methods: A retrospective analysis was conducted on 867 cases of pregnant women who had received thyroid hormone screening in early pregnancy from Jan.2018 to Jan.2019 in Guangdong Women and Children Hospital.Among them,584 cases of normal thyroid function (N)+ TPOAb (-) pregnant women were taken as the control group.Selection in the same period of subclinical hypothyroidism with TPOAb negative SCH+TPOAb(-),a total of 283 cases,112 cases without Levothyroxine treatment pregnant women as observation group,the other 171 patients who underwent Levothyroxine treatment pregnant women as treatment group.The pregnancy outcomes and obstetric complications of the three groups were compared and statistically analyzed. Results: In the observation group of pregnant women,the abortion rate,the incidence of gestational diabetes rate,the incidence rate of premature birth,the low body weight newborn was higher,the difference was statistically significant ( P <0.05).In the observation group,3.4% finally developed to clinical hypothyroidism. Conclusion: In the early period of pregnancy with subclinical hypothyroidism,L-T 4 therapy can effectively improve adverse pregnancy outcomes in patients of subclinical thyroid impairment.
作者
叶文慧
郭运忠
陈思
麦华超
范丽梅
Ye Wenhui;Guo Yunzhong;Chen Si(Department of Internal Medicine,Guangdong Women and Children Hospital,Guangzhou 511442)
出处
《现代妇产科进展》
CSCD
北大核心
2019年第12期920-922,共3页
Progress in Obstetrics and Gynecology
基金
广东省医学科研基金资助项目(No:2018467)
