摘要
目的探究妊娠期糖尿病(gestational diabetes mellitus,GDM)合并甲状腺功能减退孕妇行碘营养配合左甲状腺素治疗的效果及对妊娠结局的影响。方法选取2016年1月至2018年6月在中国人民解放军总医院第六医学中心行产前检查并分娩的186例GDM合并甲状腺功能减退孕妇为研究对象。按照随机数表法将研究对象分为研究组和对照组,每组各93例。两组患者均行血糖控制,对照组患者接受左甲状腺素常规治疗,研究组患者接受碘营养配合左甲状腺素治疗。观察两组患者碘营养状况、甲状腺相关指标、糖代谢相关指标及不良妊娠结局的发生率。结果治疗后研究组患者碘营养状况优于对照组(P<0.05);治疗后两组患者甲状腺相关指标相比治疗前均明显改善(均P<0.05),其中研究组患者促甲状腺激素水平显著低于对照组,游离甲状腺素、游离三碘甲状腺原氨酸水平均显著高于对照组(均P<0.05);治疗后两组患者糖代谢相关指标相比治疗前均明显改善(均P<0.05),其中研究组患者空腹血糖、餐后2 h血糖、糖化血红蛋白水平均显著低于对照组(均P<0.05);研究组患者不良妊娠结局中胎儿生长受限、胎儿窘迫、出生低体重、巨大儿发生率均显著低于对照组(均P<0.05)。结论碘营养配合左甲状腺素应用于GDM合并甲状腺功能减退孕妇有助于改善碘营养状况、甲状腺相关指标,降低不良妊娠结局发生率。
Objective To explore the effects of iodine nutrition combined with levothyroxine treatment and their effects on pregnancy outcome in pregnant women with gestational diabetes mellitus(GDM)and hypothyroidism.Method A total of 186 pregnant women with hypothyroidism and GDM who underwent prenatal examination and gave birth at the Sixth Medical Center Of PLA General Hospital from January 2016 to June 2018 were selected as the study subjects.All subjects were divided into study group and control group according to the random number table method,93 cases in each group.The control group received routine treatment of levothyroxine,while the study group received iodine nutrition combined with levothyroxine.The iodine nutrition status,thyroid related indexes,glucose metabolism related indexes and the incidence of adverse pregnancy outcomes in the two groups were compared.Result After treatment,the iodine nutrition status of the study group was better than that of the control group(P<0.05).After treatment,thyroid related indexes in the two groups were significantly improved compared with those before treatment(all P<0.05),among which the thyroid stimulating hormone level in the study group was significantly lower than that in the control group,and the free thyroxine and free triiodothyonine levels were significantly higher than that in the control group(all P<0.05).After treatment,the glucose metabolism related indexes in the two groups were significantly improved compared with those before treatment(all P<0.05),and the fasting plasma glucose,2h-postprandial plasma glucose and glycated hemoglobin levels in the study group were significantly lower than those in the control group(all P<0.05).The incidences of fetal growth restriction,fetal distress,low birth weight and macrosomia were significantly lower in the study group than those in the control group(all P<0.05).Conclusion Iodine nutrition combined with levothyroxine in the treatment of GDM combined with hypothyroidism can improve iodine nutritional status,thyroid and glucose metabolism indicators,and reduce the incidence of adverse pregnancy outcomes.
作者
王秀梅
邢梅
王芳
郭亚利
景蓉
WANG Xiu-mei;XING Mei;WANG Fang;GUO Ya-li;JING Rong(Department of Obstetrics and Gynecology,Sixth Medical Center,PLA General Hospital,Beijing 100048,China)
出处
《中国医学前沿杂志（电子版）》
2020年第2期49-53,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
中国人民解放军总医院第六医学中心院内课题(HLCX-2017-12)
关键词
妊娠期糖尿病
甲状腺功能减退
碘营养
妊娠结局
Gestational diabetes mellitus
Hypothyroidism
Iodine nutrition
Pregnancy outcome
