孕早期亚临床甲状腺功能异常孕妇的甲状腺超声特征及妊娠结局分析

Thyroid Ultrasound Characteristics and Pregnancy Outcome of Pregnant Women with Subclinical Thyroid Dysfunction in Early Pregnancy

目的:分析孕早期亚临床甲状腺功能异常孕妇的甲状腺超声特征及其对妊娠结局的影响。方法:选取68例孕早期亚临床甲状腺功能异常孕妇,以46例亚临床甲状腺功能亢进为A组,22例亚临床甲状腺功能减退为B组。分析两组孕妇的甲状腺超声特征和甲状腺过氧化物酶抗体(TPOAb)升高孕妇的甲状腺超声特征;对比两组孕妇妊娠结局及新生儿不良妊娠事件的发生率。结果:A组TSH降低孕妇的甲状腺实质回声均无明显异常,4例腺体血流信号轻度增多,而伴有TPOAb升高的孕妇中,4例出现甲状腺实质回声轻度弥漫性改变以及6例腺体血流信号不同程度增多。B组4例TSH升高孕妇的甲状腺实质回声轻度弥漫性改变,2例腺体血流信号轻度增多,而伴有TPOAb升高的孕妇中,9例出现甲状腺实质回声不同程度的弥漫性改变,6例腺体血流信号不同程度增多。TPOAb≥1300IU/L孕妇甲状腺实质回声异常率为100.00%,高于TPOAb<1300IU/L孕妇(P<0.05);TPOAb≥1300IU/L和TPOAb<1300IU/L孕妇甲状腺腺体血流增多发生率的对比,差异没有统计学意义(P>0.05)。两组孕妇妊娠结局和新生儿不良妊娠事件的对比,差异没有统计学意义(P>0.05)。结论:孕早期亚临床甲状腺功能异常,尤其是高水平TPOAb可引起异常甲状腺超声表现。亚临床甲状腺功能亢进与亚临床甲状腺功能减退对妊娠结局的影响可能无显著的差异。

Purpose:To analyze the ultrasonographic features of thyroid gland in the pregnant women with subclinical thyroid dysfunction in early pregnancy and its influence on the outcome of pregnancy.Method:Sixty eight pregnant women with subclinical abnormal thyroid function in early pregnancy were selected, 46 with subclinical hyperthyroidism as group A and 22 with subclinical hypothyroidism as group B. The ultrasonographic characteristics of thyroid gland and the ultrasonographic characteristics of thyroid gland in pregnant women with increased thyroid peroxidase antibody(TPOAb) were analyzed, and the pregnancy outcome and the incidence of adverse pregnancy events in neonates in the two groups were compared.Result:In group A, the echo of thyroid parenchyma was normal in the pregnant women with TSH decreased, and the blood flow signal of gland increased slightly in 4 cases. In the pregnant women with TPOAb increased, the echo of thyroid parenchyma was slightly diffused in 4 cases, and the blood flow signal of gland increased in 6 cases. In group B, the echo of thyroid parenchyma was slightly diffused in 4 pregnant women with increased TSH, and the blood flow signal of gland was slightly increased in 2 pregnant women with increased TPOAb. The abnormal echo rate of thyroid parenchyma in TPOAb≥1300 iu/l was 100.00%, higher than that in TPOAb<1300 iu/L(P<0.05);there was no significant difference between TPOAb≥1300 iu/L and TPOAb<1300 iu/L(P>0.05). There was no significant difference between the two groups(P>0.05).Conclusion:Subclinical thyroid dysfunction in early pregnancy, especially high level TPOAb can cause abnormal thyroid ultrasound. There may be no significant difference between subclinical hyperthyroidism and subclinical hypothyroidism on pregnancy outcome.