妊娠合并甲状腺功能亢进症40例的诊断和处理

Diagnosis and treatment of 40 cases of hyperthyroidism in pregnancy

目的 :探讨妊娠合并甲状腺功能亢进症 (甲亢 )的诊断、治疗及新生儿结局。 方法 :产前测定合并甲亢孕妇外周血甲状腺激素 [三碘四腺原氨酸 (T3)和甲状腺素 (T4) ]、促甲状腺素 (TSH )水平的变化 ,了解分娩方式及新生儿结局 ;通过抽脐血查 T3、T4、TSH以了解新生儿甲状腺功能。 结果 :甲亢未治疗组甲状腺激素 T3、T4、游离 T4(FT4)、游离 T3(FT3)水平明显高于治疗组和对照组 (P<0 .0 1) ,治疗组甲状腺激素水平控制在正常上限或增高 2 0 %以内。甲亢组分娩绝大多数为难产 (P<0 .0 5 ) ,占 90 %。未治疗组新生儿体质量明显低于治疗组和对照组 (P<0 .0 1) ,且有 1例新生儿甲亢出现。结论 :甲亢应早期诊断和治疗 。

Objective: To study the diagnosis, treatment and outcome of infants in patients with hyperthyroidism in pregnancy. Methods: The levels of T 3,T 4,TSH,FT 3,FT 4 in 40 cases of hyperthyroid gravida and control group were measured before delivery, the route of delivery and the outcome of infants were studied, and the neonatal thyroid functions were evaluated by the levels of T 3,T 4,TSH in cord serum samples. Results: The levels of T 3,T 4,FT 3,FT 4 in non treatment group were higher than that of treatment group and control( P <0.01); an increased rate of forceps and cesarean in hyperthyroid gravida was seen compared with that in control group, about 90%(36/40); the body weights of infants in non treatment group were lower than that in treatment and control group. There was a case of neonatal hyperthyroidism in non treatment group. Conclusion: Hyperthyroidism should be diagnosed and treated earlier and there is little side effects on the outcome of infants.