甲状腺功能亢进对妊娠结局的影响

Study on the impact of hyperthyroidism on pregnancy outcome

目的探讨妊娠期甲状腺功能亢进对妊娠结局的影响。方法回顾性分析80例妊娠合并甲状腺功能亢进症患者（甲亢组）的临床资料，按照妊娠期治疗是否规范分为治疗组（61例）及未治组（19例）；同时按照1：2比例随机选择160例健康妊娠妇女为对照组。比较三组间分娩情况、母体及围生儿结局等差异。结果甲亢组妊娠高血压疾病发病率10．0％、心力衰竭发生率3．8％、剖宫产率61．4％、早产发生率7．6％、窒息发生率7．6％、甲状腺功能低下发生率3．8％、病死率3．8％，与对照组的1．3％、41．3％、1．3％、0．6％、0、0相比较，差异均有统计学意义（均P〈0．05），两组新生儿畸形发生率无差异（P〉0．05）；治疗组妊娠高血压疾病、心力衰竭、早产、窒息等发生率分别为3．3％、3．3％、3．3％、0，病死率0，与未治组的31．6％、15．8％、21．1％、15．8％、10．5％相比较，差异均有统计学意义（均P〈0．05），而两组甲状腺功能低下发生率、刮宫产率、畸形发生率等差异无统计学意义。结论甲状腺功能亢进可增加妊娠并发症的发生率，规范治疗可改善妊娠结局。

Objective To discuss the impact of hyperthyroidism on pregnancy outcome. Methods Clinical data of 80 pregnancy patients with hyperthyroidism （hyperthyroidism group） were retrospectively analyzed, in accord- ance with the norms of treatment during pregnancy is divided into treatment group（61 cases） and untreated group（ 19 cases） ;At the same time ,in accordance with the ratio of 1 ： 2 160 cases of heahhy pregnant women were randomly se- lected as control group, childbirth, the maternal and perinatal outcome in three groups were compared. Results Graves disease group the incidence of pregnancy-induced hypertension 10.0% ,3.8% incidence of heart failure, cesarean section rate of 61.4% ,7. 6% incidence of prematurity, asphyxia incidence of 7. 6%, a low incidence of 3. 8% ,the mortality rate 3. 8% ,and 1.3% of the control group,41.3% ,1.3% ,0. 6% ,0,0,the differences were sta- tistically significant （ P 〈 0. 05 ）, the incidence of neonatal abnormalities in two groups is not different （ P 〉 0. 05 ） ; the treatment group of diseases of pregnancy-induced hypertension, heart failure, premature birth, asphyxia, such as the incidence were 3.3%, 3. 3%, 3.3%, 0,0 mortality, with non-governing group of 3 I. 6% , 15.8%, 21.1% , 15. 8%, 10. 5%. The differences were statistically significant（ P 〈0. 05） ,and a low incidence of the two groups,the cesarean section rate,incidence of deformities such as no difference. Conclusion Hyperthyroidism can increase the incidence of pregnancy complications, and standardize the treatment can improve pregnancy outcome.