甲状腺功能检测在甲状腺功能减退孕妇中的应用

Application of thyroid function test in pregnant women with hypothyroidism

目的探讨甲状腺功能检测在甲状腺功能减退孕妇中的临床应用价值。方法选择2014年6月至2016年6月河南科技大学附属黄河三门峡医院产科收治的甲状腺功能减退孕妇60例作为观察组,选择同时期健康孕妇60例作为对照组。于孕8周时检测并比较两组孕妇的甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPOAb)水平,并观察两组孕妇的母胎并发症发生情况。结果观察组孕妇的TSH、TPOAb水平分别为(34.97±16.34)u IU/m L、(468.21±130.32)IU/m L,明显高于对照组的(2.01±0.42)u IU/m L、(16.18±8.43)IU/m L,FT3、FT4分别为(1.54±0.34)pmol/m L、(4.30±2.01)pmol/m L,明显低于对照组的(5.29±1.56)pmol/m L、(19.05±4.98)pmol/m L,差异均有显著统计学意义(P<0.01);对照组孕妇的母胎并发症为6.67%,明显低于观察组的28.33%,差异有统计学意义(P<0.05)。结论甲状腺功能减退孕妇的甲状腺功能指标异常,母胎并发症发生风险增加,临床应全面检查并对症治疗,以改善妊娠结局,确保分娩安全性。

Objective To investigate the clinical value of thyroid function test in pregnant women with hypo-thyroidism. Methods A total of 60 pregnant women with hypothyroidism admitted in Huanghe Sanmenxia of HenanUniversity of Science and Technology from June 2014 to June 2016 were selected as the observation group, and 60healthy pregnant women in the same period were selected as the control group. At 8 weeks of pregnancy, thyroid hor-mone （TSH）, free three triiodothyronine （FT3）, free thyroxine （FT4）, thyroid peroxidase antibody （TPOAb） levels werecompared between the two groups, and maternal complications occurred in two groups of pregnant women were ob-served. Results TSH and TPOAb levels were （34.97±16.34） uIU/mL, （468.21±130.32） IU/mL in the observation group,significantly higher than （2.01±0.42） uIU/mL, （16.18±8.43） IU/mL in the control group （P〈0.05）. FT3 and FT4 levelswere （1.54±0.34） pmol/mL, （4.30±2.01） pmol/mL in the observation group, significantly lower than （5.29±1.56） pmol/mL,（19.05±4.98） pmol/mL in the control group. The incidence of maternal complications was 6.67% in the control group,significantly lower than 28.33% in the observation group （P〈0.05）. Conclusion Pregnant women with hypothyroid-ism have abnormal thyroid function indexes, increased risk of maternal complications, which should be given compre-hensive examination and symptomatic treatment, in order to improve the outcome of pregnancy and ensure the safetyof delivery.