妊娠期亚临床甲状腺功能减退症对其后代智力的影响及干预效果分析

Influence of Subclinical Hypothyroidism in Pregnancy on the Intellectual Development of Their Offspring and Analysis of Levothyroxine Intervention

目的探讨妊娠期亚临床甲状腺功能减退症(甲减)及左甲状腺素(LT4)干预对后代智力水平的影响。方法对育龄妇女266人进行甲状腺功能(甲功)、甲状腺B超检测,确定本地区育龄妇女甲功正常值;根据本地区甲功正常值选取51例正常组、50例亚临床甲减观察组(观察组)、49例亚临床甲减治疗组(治疗组)及33例低游离甲状腺素组(低FT4组)人群,并对治疗组进行LT4的干预,对各组人群子女分别在半岁、1岁、3岁行盖瑟尔量表测评。结果观察组与正常组相比,其子女在半岁时大运动发育商(GMQ)(101.78比104.92)、语言发育商(LQ)(99.31比101.85)、1岁时GMQ(103.12比106.27)、LQ(100.24比103.25)、精细动作发育商(FMQ)(101.66比103.96)、3岁时GMQ(100.39比104.04)、LQ(103.06比106.55)、个人社交发育商(ISBQ)(103.10比106.41)、FMQ(103.72比106.86)均出现明显下降。结论亚临床甲减可影响后代的智力水平,并随年龄的增加差异增大;对亚临床甲减进行早期的干预治疗能改善后代的智力水平;低FT4血症对后代智力水平影响不明显。

Objective To investigate the impact of subclinical hypothyroidism in pregnancy on the intellectual development of offspring, and evaluated the effect Levothyroxine intervention. Methods The normal values of thyroid function in kramay were determined from 266 women of repmduefive ages whom received thyroid function test and thyroid B ultrasound analysis. According to the kramay local normal value of thyroid function, 51 pregnant women with normal thyroid function （ normal group） were refen＇ed as normal ; 50 pregnant women with subclinical hypothyroidism were enrolled in the SCH group and 49 who received levothyroxine therapy as LT4 group ; 33 pregnant women with low free thyroxine were enrolled as low FF4 group. The intellectual development of all the women＇s offspring was assessed using the Gesell developmental scale during their half year, one year and three years old of life. Results The GMQ （ 101.78 vs 104.92 ） and LQ （99.31 vs 101.85 ） in half year, the GMQ （ 103.12 vs 106.27 ）, LQ （ 100.24 vs 103.25 ）and FMQ （ 101.66 vs 103.96 ） in one year, the GMQ （ 100.39 vs 104.04）, LQ （ 103.06 vs 106.55 ）, FMQ （ 103.72 vs 106.86 ） and ISBQ （ 103.10 vs 106.41 ） in three years old were ＇all significanlly lower in the SCH group compared with nornm] group. There were no significant- ly differences among noormal group, Low FF4 group and LT4 group. Conclusion Subclinical hypothyroidism may influence offspring intelligence development, and this difference increased with the increase of age. The FF4 early intervention can improve the intellectual development of the Subclinieal hypothyroidism women＇ s offspring. The low FF4 does not affect the level of children＇ s intelligence.