不同时期妊娠期高血压疾病孕妇与甲状腺功能减退相关性研究

Study of the correlation of hypertensive disorder complicating pregnancy and thyroid function decrease in different pregnant periods

目的探讨不同时期妊娠期高血压疾病与甲状腺功能减退的相关性。方法收集2014年1月至2016年11月在成都市第七人民医院妇产科门诊建卡就诊的孕产妇资料,其中妊娠期高血压疾病患者39例设为研究组,47例正常孕产妇为对照组,检测两组孕产妇促甲状腺激素(thyroid stimulating hormone,TSH)和游离甲状腺素(free thyroxine,FT_4)水平。结果两组孕妇TSH水平随孕期增加而逐渐上升,研究组孕中、晚期TSH值高于同期对照组(P<0.05);两组孕妇FT_4水平随孕周增加呈下降趋势,研究组孕中、晚期FT_4值低于同期对照组(P<0.05);研究组孕妇的甲状腺功能随病情的加重而明显减退(P<0.05);两组孕妇临床甲状腺功能减退的孕早、中、晚期的累积发病率比较差异无统计学意义(P>0.05);亚临床甲减的发病情况,孕早期两组差异无统计学意义(P>0.05),孕中、晚期研究组累积发病率高于同期对照组(P<0.05)。结论妊娠期高血压疾病与甲状腺功能减退高度相关,妊娠期高血压疾病可能作为高危因素参与到妊娠期甲状腺功能减退中。

Objective To investigate the correlation of hypertensive disorder complicating pregnancy and thyroid function decrease in different pregnant periods. Methods The data of pregnant women who came to obstetric clinic in the 7th People＇ s Hospital of Chengdu for antenatal care from January 2014 to November 2016 were collected. Among them, 39 cases of hypertensive patients during pregnancy were divided into study group and 47 cases of normal pregnant women as control group. The levels of thyroid stimulating hormone （TSH） and free thyroxine （FI＂4 ） in both groups were detected. Results The level of TSH in both groups rose gradually with gestational age. The level of TSH in study group were significant higher than the control group in second trimester and last trimester（ P 〈 0. 05 ）. The level of FT4 in both groups declined with gestational age. The level of FT4 had the significant difference between two groups in second trimester and last trimester（ P 〈 0. 05 ）. The thyroid function of pregnant women in study group decreased significantly with the aggravation of the disease （ P 〈 0. 05 ）. The cumulative incidence of clinical hypothyroidism had no significant difference between two groups in the pregnancy （ P 〉 0.05 ）. The cumulative incidence of subclinical hypothyroidism in study group were significant higher than the same period of control group in second trimester and last trimester（ P 〈 0.05 ）, whereas there was no significant difference in the first trimester （P 〉 0. 05）. Conclusion Hypertensive disorder complicating pregnancy had high correlation with the thyroid function decrease, and the HDCP might be as high - risk factor participate in the thyroid function decrease in the pregnancy.