妊娠期亚临床甲状腺功能减退症中促甲状腺激素异常与血脂关系的研究

Study on the relationship between abnormal thyroid stimulating hormone and blood lipids in patients with subclinical hypothyroidism during pregnancy

目的分析妊娠期亚临床甲状腺功能减退症中促甲状腺激素(TSH)异常孕妇的血脂变化,为改善妊娠期亚临床甲状腺功能减退症患者的妊娠结局积累资料。方法对2014年1-8月就诊于乌鲁木齐市妇幼保健院的2 056名汉族孕妇进行筛查,筛查出亚临床甲状腺功能减退症孕妇406例(TSH异常220例、低T4血症186例、TPOAb阳性30例),选取TSH异常孕妇220例为病例组,非亚临床甲状腺功能减退症孕妇1 650例为对照组进行研究。结果孕早期两组血脂水平比较,差异无统计学意义(P>0.05);孕中、晚期病例组TC、TG、LDL水平高于对照组,两组比较,差异有统计学意义(P<0.05)。孕中期病例组HDL低于对照组,两组比较,差异有统计学意义(P<0.05)。结论 TSH异常妊娠期亚临床甲状腺功能减退症孕妇血脂水平增高,存在血脂紊乱。

Objective To analyze the changes of blood lipids among the pregnant women with subclinical hypothyroidism during preg- nancy and abnormal thyroid stimulating hormone （ TSH）, provides some information for improving pregnancy outcome of patients with sub- clinical hypothyroidism during pregnancy. Methods A total of 2 056 Han pregnant women were selected from the hospital from January to August in 2014, 406 women with subclinical hypothyroidism during pregnancy were screened out, 220 cases with abnormal TSH, 186 cases with low T4 concentration, and 30 cases with positive TPOAb were included; 220 pregnant women with abnormal TSH were selected as case group; 1 650 pregnant women with subclinical hypothyroidism during pregnancy were selected as control group. Results There was no sta- tistically significant difference in the levels of blood lipids during the first trimester of pregnancy between the two groups （P〉0. 05） ; the lev- els of TC, TG, and LDL during the second and the third trimesters of pregnancy in case group were statistically significantly higher than those in control group （P〈0. 05） . The level of HDL during the second trimester of pregnancy in case group was statistically significantly lower than that in control group （P〈0.05） . Conclusion The levels of blood lipids in the pregnant women with abnormal TSH and subclinieal hypothyroidism during pregnancy increase, blood lipid disorders exist among these women.