佛山地区妊娠中、晚期妇女甲状腺疾病特点的研究

Study the thyroid disease feature of pregnant women in the second and the third trimester in foshan region

目的探讨佛山地区妊娠中、晚期妇女甲状腺疾病的特点。方法选择佛山地区妊娠中期（孕16～24周）孕妇222例为中孕组，妊娠晚期（孕37～41^＋6周）孕妇113例为晚孕组，另选择同期在本院进行健康体检的非妊娠育龄妇女为非孕妇组，共204例，应用电化学发光免疫检测技术检测血中游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）及促甲状腺激素（TSH）的值。按如下标准确定诊断：TSH〈0．34mlU／ml，FT3和／或FT4升高者，诊断为甲状腺功能亢进（甲亢）；TSH〈0．34mlU／ml，m和b-T4正常者诊断为亚临床甲亢；TSH〉4．8mlU／ml，FT3和／或FT4降低者诊断为甲状腺功能减退（甲减），TSH〉4．8mlU／ml，FT3和FT4正常者诊断为亚临床甲减。结果①比较甲状腺疾病患病率，中孕组与非孕妇组比较，P〉0．05，差异无统计学意义，晚孕组分别与中孕组及非孕妇组比较，P〈0．05，差异有统计学意义，晚孕组的甲状腺疾病患病率明显高于中孕组及非孕妇组。②比较甲状腺疾病的类型，各组的甲状腺疾病类型不同。组内甲亢（含亚临床甲亢）与甲减（含亚临床甲减）的患病率比较，在非孕妇组中，P〉0．05，差异无统计学意义；中孕组中，P〈0.05，差异有统计学意义，甲亢患病率明显高于甲减；晚孕组中，P〈0．05，差异有统计学意义，甲亢患病率明显高于甲减。③组间比较甲亢与甲减患病率，中孕组与晚孕组比较，P〉0．05，差异无统计学意义；中孕组与非孕妇组比较，P〉0．05，差异无统计学意义；晚孕组与非孕妇组比较甲亢患病率，P〈0．05，差异有统计学意义，晚孕组甲亢的患病率明显高于非孕妇组，比较甲减患病率，P〉0．05，差异无统计学意义。结论沿海城市孕中晚期妇女甲状腺疾病的类型以甲亢为主，建议通过孕中期开始定期检测甲状腺功能，及时发现和治疗甲状腺功能异常，从而减少对母胎的危害。

Objective： To study the thyroid disease feature of pregnant women in the second and the third trimester in Foshan region. Methods： Select 222 cases of pregnant women in the second trimester in Foshan region as middle gravidity group （ 16 - 24 weeks of gestation）, 113 cases of pregnant women in the third trimester as late gravidity group （37 -41^＋6 weeks of gestation）, and select 204 cases of homeochronous non- gestation reproductive aged women who have active and well health examination in our hospital as non -pregnant women group. Applicate iinmunodetect technique to detect the degree of F13, FT4, TSH in blood. The diagnositic criteria is： 1. Hyperthyroidism： TSH 〈 0.34mlU/ml, FI3 and/or FT4 is setting up; 2. Deuto- hyperthyroidism： TSH 〈 0.34mlU/ml, FT3 and FT4 are in normal; 3. Hypothyroidism： TSH 〉 4. 8mlU/ml, F13 and/or FT4 is cutting down; 4. Deuto - hypothyroidism： TSH 〉 4. 8mlU/ml, F13 and FF4 are in normal. Results ： （1）To compare the morbidity rate of thyroid disease with middle gravidity group and non -pregnant women group, the rate had no significant difference （ P 〉0. 05）. To compare late gravidity group with middle gravidity group and compare late gravidity group with non -pregnant women group, the rate had significant difference （ P 〈0. 05）. The morbidity rate of thyroid disease in late gravidity group is significantly higher than in middle gravidity group and non -pregnant women group. （2）To compare the type of thyroid disease. The type of thyroid disease in different groups is distinct. Inner group compare the morbidity rate of hyperthyroidism （include deuto-hyperthyroidism） and hypothyroidism （include deuto- hypothyroidism）, there is no significant difference in non- pregnant women group （ P 〉0. 05）. There is significant difference in middle gravidity group （ P 〈0. 05）, the morbidity rate of hyperthyroidism is significantly higher than of hypothyroidism. And there is significant difference in late gravidity group （ P 〈 0. 05）, the morbidity rate of hyperthyroidism is significantly higher than of hypothyroidism. （3）Group comparision the morbidity rate of hyperthyroidism with hypot- hyroidism. Compare the rate in middle gravidity group with in late gravidity group , the rate has no significant difference （ P 〉 0. 05）. Compare the rate in middle gravidity group with in non -pregnant women group , the rate has no significant difference （ P 〉0. 05）. Compare the morbidity rate of hyperthyroidism in late gravidity group with in non - pregnant women group, the morbidity rate of hyperthyroidism has no significant difference （ P 〈0. 05）, the rate in late gravidity group is higher than in non-pregnant women group. And compare the morbidity rate of , in late gravidity group with in non -pregnant women group , the rate has no significant difference （ P 〉0. 05）. Concludsion： In the city along the coast the type of thyroid disease is hyperthyroidism of pregnant women in the second and the third trimester. We suggest the pregnant women in the second trimester examing the functian of thyroid regularly. We can promptly found and treatment the abnormality of thyroid function, in order to reduce the matemofetal harm.