妊娠早期甲状腺功能异常对妊娠糖尿病的影响

Impact of thyroid dysfunction during early pregnancy on gestational diabetes

目的探析妊娠早期甲状腺功能异常对妊娠糖尿病的影响。方法随机选择本院2013年1月-2015年12月接收的3 408例12孕周妇女,通过化学发光法检测甲状腺功能,并于24周进行75 g糖耐量检测。按照甲状腺功能异常及治疗情况分组,将甲状腺功能正常的2 571例作为正常组,将临床甲状腺功能减退(简称"甲减")治疗组、亚临床甲减治疗组、亚临床甲减未治疗组、单纯低FT4血症与甲亢组837例孕妇作为异常组,分析甲状腺功能异常与妊娠糖尿病的关系。结果亚临床甲减未治疗组、单纯低FT4血症组与甲亢组妊娠妇女发生妊娠糖尿病明显高于正常组,差异有统计学意义(P<0.05),而亚临床甲减治疗组、临床甲减治疗组与正常组比较,差异无统计学意义(P>0.05)。结论妊娠早期甲状腺功能异常、单纯低FT4血症、甲亢要尽早治疗,以减少对妊娠糖尿病的影响及不良妊娠结局的发生。

Objective To analyze the impact of thyroid dysfunction during early pregnancy on gestational diabetes mellitus.Methods From Jan. 2013 to Dec. 2015,3 408 pregnant women in our hospital were randomly selected to receive a test of thyroid function via chemiluminescence method at their 12 weeks and a test of 75 g glucose tolerance at their 24 weeks. It was divided into two groups to analyze the relationship between thyroid dysfunction and gestational diabetes mellitus on the basis of thyroid dysfunction and treatment condition,of which,2 571 pregnant women with normal thyroid function were served as control group,837 pregnant women,including clinical hypothyroidism treatment group,subclinical hypothyroidism treatment group,subclinical hypothyroidism untreated group,low FT4 hyperlipidemia group and hyperthyroidism group,were taken as abnormal group. Results The gestational diabetes mellitus in the subclinical hypothyroidism untreated group,low FT4 hyperlipidemia group and hyperthyroidism group was significantly higher than that in the control group,with the difference statistically significant（ P〈0. 05）,but the difference between clinical hypothyroidism treatment group and subclinical hypothyroidism treatment group had no statistical significance,compared to the control group（ P〈0. 05）. Conclusion Early thyroid dysfunction,low FT4 hyperlipidemia and hyperthyroidism should be treated as early as possible so as to reduce its impact on gestational diabetes mellitus and to avoid adverse pregnancy outcomes.