目的 观察个体化甲状腺激素替代疗法治疗妊娠期亚临床甲状腺功能减退症(SCH)的效果及对母婴结局的影响。方法 选取2021年9月—2022年4月黄冈市妇幼保健院收治的妊娠期SCH患者76例,按照信封法分为观察组和对照组,各38例。在常规干预基础...目的 观察个体化甲状腺激素替代疗法治疗妊娠期亚临床甲状腺功能减退症(SCH)的效果及对母婴结局的影响。方法 选取2021年9月—2022年4月黄冈市妇幼保健院收治的妊娠期SCH患者76例,按照信封法分为观察组和对照组,各38例。在常规干预基础上,对照组予常规甲状腺激素替代疗法治疗,观察组予个体化甲状腺激素替代疗法治疗,2组均用药至分娩。比较2组治疗前后(分娩前1 d)TSH水平变化,分娩方式(自然分娩、产钳助产和剖宫产)、妊娠期并发症(妊娠期高血压、妊娠期糖尿病)、围生期并发症(早产、胎盘早剥、产后出血)、新生儿Apgar评分(1 min Apgar评分与5 min Apgar评分)、新生儿不良结局(低体质量儿、畸形、窒息)。结果 治疗后,2组TSH水平较治疗前下降,且观察组低于对照组(P<0.01)。观察组自然分娩率为92.11%,高于对照组的71.05%(χ^(2)=5.604,P=0.018);观察组妊娠期并发症总发生率及各围生期并发症发生率均低于对照组,观察组新生儿1 min Apgar评分、5 min Apgar评分均高于对照组(P<0.05或P<0.01);观察组新生儿不良结局总发生率为5.26%,低于对照组的26.32%(χ^(2)=6.333,P=0.012)。结论 个体化甲状腺激素替代疗法治疗妊娠期SCH的效果肯定,对母婴结局亦有积极影响。展开更多
目的:分析妊娠期亚临床甲状腺功能减退症(SCH)孕妇血清可溶性白细胞介素-2受体(SIL-2R)、同型半胱氨酸(HCY)的表达意义及与妊娠结局的关系。方法:选择我院自2021年1月至2023年6月收治的120例妊娠期SCH孕妇(观察组)及120例正常妊娠孕妇(...目的:分析妊娠期亚临床甲状腺功能减退症(SCH)孕妇血清可溶性白细胞介素-2受体(SIL-2R)、同型半胱氨酸(HCY)的表达意义及与妊娠结局的关系。方法:选择我院自2021年1月至2023年6月收治的120例妊娠期SCH孕妇(观察组)及120例正常妊娠孕妇(对照组);检测两组血清SIL-2R、HCY表达水平,分析血清SIL-2R、HCY与促甲状腺激素(TSH)的关系,通过受试者工作特征曲线(ROC)下面积(AUC)评价观察组血清SIL-2R联合HCY对妊娠结局不良的预测效能。结果:观察组妊娠期碘摄入量偏少比例、TPOAb阳性率和TGAb阳性率均高于对照组,差异均有统计学意义(P Objective: To analyze the expression significance of serum soluble interleukin-2 receptor (SIL-2R) and homocysteine (HCY) in pregnant women with subclinical hypothyroidism (SCH) during pregnancy and their relationship with pregnancy outcome. Methods: 120 SCH pregnant women (observation group) and 120 normal pregnant women (control group) admitted to our hospital from January 2021 to June 2023 were selected. The expression levels of serum SIL-2R and HCY in the two groups were detected, and the relationship between serum SIL-2R and HCY and thyroid stimulating hormone (TSH) was analyzed. The predictive efficacy of serum SIL-2R combined with HCY in the observation group was evaluated by area under receiver operating characteristic curve (ROC) (AUC). Results: The proportion of low iodine intake, TPOAb positive rate and TGAb positive rate in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). The expression levels of serum SIL-2R and HCY in observation group were higher than those in control group, and the differences were statistically significant (P < 0.05). By Pearson correlation analysis, serum SIL-2R and HCY expression levels of SCH pregnant women were positively correlated with TSH (P < 0.05). Logistic regression analysis showed that low iodine intake and high levels of serum SIL-2R and HCY were independent influencing factors of SCH during pregnancy (P < 0.05). The levels of serum SIL-2R and HCY in the adverse pregnancy outcome group were higher than those in the normal pregnancy outcome group, with statistical significance (P < 0.05). ROC curve analysis showed that the specificity, sensitivity and AUC of serum SIL-2R combined with HCY in predicting adverse pregnancy outcomes of SCH pregnant women were 62.81%, 88.69% and 0.931 respectively. Conclusion: The increase of serum SIL-2R and HCY expression levels is closely related to the occurrence of SCH during pregnancy, and the combination of the two can predict the adverse pregnancy outcome of pregnant women, which is worthy of clinical attention.展开更多
文摘目的 观察个体化甲状腺激素替代疗法治疗妊娠期亚临床甲状腺功能减退症(SCH)的效果及对母婴结局的影响。方法 选取2021年9月—2022年4月黄冈市妇幼保健院收治的妊娠期SCH患者76例,按照信封法分为观察组和对照组,各38例。在常规干预基础上,对照组予常规甲状腺激素替代疗法治疗,观察组予个体化甲状腺激素替代疗法治疗,2组均用药至分娩。比较2组治疗前后(分娩前1 d)TSH水平变化,分娩方式(自然分娩、产钳助产和剖宫产)、妊娠期并发症(妊娠期高血压、妊娠期糖尿病)、围生期并发症(早产、胎盘早剥、产后出血)、新生儿Apgar评分(1 min Apgar评分与5 min Apgar评分)、新生儿不良结局(低体质量儿、畸形、窒息)。结果 治疗后,2组TSH水平较治疗前下降,且观察组低于对照组(P<0.01)。观察组自然分娩率为92.11%,高于对照组的71.05%(χ^(2)=5.604,P=0.018);观察组妊娠期并发症总发生率及各围生期并发症发生率均低于对照组,观察组新生儿1 min Apgar评分、5 min Apgar评分均高于对照组(P<0.05或P<0.01);观察组新生儿不良结局总发生率为5.26%,低于对照组的26.32%(χ^(2)=6.333,P=0.012)。结论 个体化甲状腺激素替代疗法治疗妊娠期SCH的效果肯定,对母婴结局亦有积极影响。
文摘目的:分析妊娠期亚临床甲状腺功能减退症(SCH)孕妇血清可溶性白细胞介素-2受体(SIL-2R)、同型半胱氨酸(HCY)的表达意义及与妊娠结局的关系。方法:选择我院自2021年1月至2023年6月收治的120例妊娠期SCH孕妇(观察组)及120例正常妊娠孕妇(对照组);检测两组血清SIL-2R、HCY表达水平,分析血清SIL-2R、HCY与促甲状腺激素(TSH)的关系,通过受试者工作特征曲线(ROC)下面积(AUC)评价观察组血清SIL-2R联合HCY对妊娠结局不良的预测效能。结果:观察组妊娠期碘摄入量偏少比例、TPOAb阳性率和TGAb阳性率均高于对照组,差异均有统计学意义(P Objective: To analyze the expression significance of serum soluble interleukin-2 receptor (SIL-2R) and homocysteine (HCY) in pregnant women with subclinical hypothyroidism (SCH) during pregnancy and their relationship with pregnancy outcome. Methods: 120 SCH pregnant women (observation group) and 120 normal pregnant women (control group) admitted to our hospital from January 2021 to June 2023 were selected. The expression levels of serum SIL-2R and HCY in the two groups were detected, and the relationship between serum SIL-2R and HCY and thyroid stimulating hormone (TSH) was analyzed. The predictive efficacy of serum SIL-2R combined with HCY in the observation group was evaluated by area under receiver operating characteristic curve (ROC) (AUC). Results: The proportion of low iodine intake, TPOAb positive rate and TGAb positive rate in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). The expression levels of serum SIL-2R and HCY in observation group were higher than those in control group, and the differences were statistically significant (P < 0.05). By Pearson correlation analysis, serum SIL-2R and HCY expression levels of SCH pregnant women were positively correlated with TSH (P < 0.05). Logistic regression analysis showed that low iodine intake and high levels of serum SIL-2R and HCY were independent influencing factors of SCH during pregnancy (P < 0.05). The levels of serum SIL-2R and HCY in the adverse pregnancy outcome group were higher than those in the normal pregnancy outcome group, with statistical significance (P < 0.05). ROC curve analysis showed that the specificity, sensitivity and AUC of serum SIL-2R combined with HCY in predicting adverse pregnancy outcomes of SCH pregnant women were 62.81%, 88.69% and 0.931 respectively. Conclusion: The increase of serum SIL-2R and HCY expression levels is closely related to the occurrence of SCH during pregnancy, and the combination of the two can predict the adverse pregnancy outcome of pregnant women, which is worthy of clinical attention.
