妊娠亚临床甲状腺功能减退症管理与干预模式探讨

Mode of management and intervention on subclinical hypothyroidism of pregnancy

目的：了解妊娠期甲状腺功能减退症发病率对妊娠结局影响,探讨新型干预模式。方法：深圳市宝安区妇幼保健院产前门诊自2008年1月1日~2009年12月30日对2 928例孕前有高危因素及孕期系统保健的妇女进行甲状腺功能筛查：利用化学发光法检测血清FT3、FT4、TSH。结果：正常2 525例,占86.23%;异常403例,占13.76%,其中低T4血症127例,占4.43%,TSH升高（亚临床甲减者）139例,占4.75%,甲减103例,占3.51%,甲亢34例,占1.16%。针对筛查监测结果,建立早期干预新模式及效果评价,干预后甲减5例,占1.24%,亚临床甲减30例,占7.45%,低T4血症7例,占1.74%。结论：干预组亚临床甲减病症、低T4血症发生率低,早期干预可以减少并发症及出生缺陷的发生。

Objective：By observing the influence of hypothyroidism in gestational period on gestational outcome to explore the new intervention mode.Methods：From Jan.1,2008 to Dec.30,2009,2 928 cases of women with progestational high-risk factors and systemic healthcare during gestation accepted screening of thyroid gland function in antenatal clinic of this hospital.Serum FT3,FT4 and TSH were detected by chemoluminescence assay.Results：2 525 cases were normal（86.23%）,of 403 abnormality（13.76%）,127 cases of low T4（4.43%）,139 cases of higher TSH（subclinical hypothyroidism）（4.75%）,103 hypothyroidism（3.51%）,34 hyperthyroidism（1.16%）.According to the results,the intervention measures were carried out,then 5 hypothyroidism（1.24%）,30 subclinical hypothyroidism（7.45%）,7 low T4（1.74%）.Conclusion：Early intervention could reduce the occurrence of complication and birth defect.