早期治疗妊娠期甲状腺功能亢进对母婴的身体健康影响分析

Analysis on the Treatment of Anti-hyperthyroidism to the Maternal and Child Health in the Early Gestational Period

目的探讨妊娠期甲状腺功能亢进妇女早期治疗对母婴健康的影响。方法回顾性分析我院2011年至2013年收治的88例妊娠期合并轻中度甲亢患者的临床资料,根据患者治疗方案分为甲硫咪唑组(28例)、丙硫氧嘧啶组(28例)和对照组(32例),比较三组妊娠妇女妊娠期间的疾病变化情况及母婴情况。结果 1治疗后三组患者FT3、FT4、TSH水平差异具有统计学意义(P<0.05),并且甲硫咪唑治疗组和丙硫氧嘧啶治疗组患者的FT3、FT4、TSH水平差异具有统计学意义(P<0.05);2三组新生儿FT3、FT4、TSH水平差异具有统计学意义(P<0.05),并且甲硫咪唑治疗组和丙硫氧嘧啶治疗组新生儿FT3、FT4、TSH水平差异具有统计学意义(P<0.05);3两治疗组患者妊高症发生率、早产发生率和平均分娩孕周与对照组比较差异均具有统计学意义(P<0.05),并且甲硫咪唑治疗组和丙硫氧嘧啶治疗组患者的平均分娩孕周差异具有统计学意义(P<0.05);4甲硫咪唑治疗组和丙硫氧嘧啶治疗组新生儿低体重出生率、胎儿窘迫率和出生体重与对照组比较差异也具有统计学意义(P<0.05),甲硫咪唑治疗组和丙硫氧嘧啶治疗组新生儿出生体重差异均具有统计学意义(P<0.05)。结论早期采取甲硫咪唑或丙硫氧嘧啶对妊娠期甲状腺功能亢进妇女进行治疗对母婴健康、提高新生儿出生质量均有积极作用,并且甲硫咪唑作用更佳,可作为妊娠期甲状腺功能亢进的首选治疗。

Objective To explore the effect of anti-hyperthyroidism treatment to the maternal and child health in the early gestational period. Methods The clinical data of 88 gestational women complicated with mild to moderate hyperthyroidism were retrospectively analyzed. All cases were divided into Methimazole Group （28 cases）, Propylthiouracil Group （28 cases） and Control Group （32 cases） according to their therapeutic regimen. Disease changes and pregnancy outcome were analyzed in three groups. Results The serum levels of FT3 , FT4 and TSH of pregnant women in three groups were significantly different （ P 〈 0.05 ）. The serum level of FT3, FT4, TSH of newborn infants in three groups were significantly different （ P 〈 0.05 ）. Pregnancy- induced hypertension incidence, premature delivery incidence and mean gestational weeks in both treatment groups were significantly different compared with those in control group （ P 〈 0.05 ）, and mean gestational weeks in Methimazole Group and Propyhhiouracil Group was significantly different （P 〈 0.05 ）. The birth rate of low weight, fetal distress incidence, and mean birth weight in both treatment groups were significantly different compared with those in control group （ P 〈 0.05 ）, and mean birth weight in Methimazole Group and Propyhhiouracil Group was significantly different （P 〈 0. 05 ）. Conclusion Treatment of Methimazole and Propyhhiouracil to women with pregnant hyperthyroidism could improve the maternal and child health in the early gestational period, and the Propylthiouracil treatment has better effect.