妊娠期糖尿病孕妇甲状腺功能变化的研究

Study of changes of thyroid function in pregnant women with gestational diabetes mellitus

目的探讨妊娠期糖尿病患者甲状腺功能的变化。方法回顾性分析2017年7月~2018年6月在医院诊断为妊娠期糖尿病的90例孕妇,将其作为观察组,另选择同期无妊娠期合并症的100例孕妇作为对照组。比较两组孕妇孕早期、孕中期以及孕晚期的外周血三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、血清促甲状腺素(TSH)水平以及抗甲状腺过氧化物酶抗体(TPOAb)阳性率。结果两组孕早期的T3、T4、FT3、FT4、TSH水平以及TPOAb阳性率比较,差异无统计学意义(P>0.05)。观察组孕中期的T3水平、TPOAb阳性率显著高于对照组,差异有统计学意义(P<0.05);两组孕中期的T4、FT3、FT4、TSH比较,差异无统计学意义(P>0.05)。观察组孕晚期的T4水平显著低于对照组,TPOAb阳性率显著高于对照组,差异有统计学意义(P<0.05);两组孕晚期的T3、FT3、FT4、TSH水平比较,差异无统计学意义(P>0.05)。结论妊娠期糖尿病患者在孕中期的T3水平显著升高,孕晚期的T4水平显著下降,孕中期的TPOAb阳性率最高,孕晚期的TPOAb阳性率有所下降,但仍然处于较高水平。

Objective To discuss the change of thyroid function in pregnant women with gestational diabetes mellitus.Methods A retrospective analysis was made on 90 pregnant women with gestational diabetes diagnosed from July 2017 to June 2018 in hospital, they were selected as the observation group. Another 100 pregnant women without complications of pregnancy in the same period were selected as the control group. The levels of triiodohyronine(T3), thyroxine(T4), free triiodothyronine(FT3), free thyroxine(FT4), thyraid-stinuslating hormore(TSH) and the positive rate of thyroperaseidase ourtibadies(TPOAb) in peripheral blood of the two groups were compared in early pregnancy, mid-pregnancy and late pregnancy. Results There was no significant difference in the levels of T3, T4, FT3, FT4, TSH and the positive rate of TPOAb between the two groups in early pregnancy(P>0.05). In the second trimester of pregnancy, the level of T3 and the positive rate of TPOAb in the observation group were significantly higher than those in the control group,with significant difference(P<0.05). There was no significant difference in the level of T4, FT3, FT4 and TSH between the two groups in the second trimester of pregnancy(P>0.05). In the third trimester of pregnancy, the level of T4 of the observation group was significantly lower than that of the control group, and the positive rate of TPOAb was significantly higher than that of the control group, with significant difference(P<0.05). There was no significant difference in the level of T3, FT3, FT4 and TSH between the two groups in the third trimester of pregnancy(P>0.05). Conclusion The level of T3 of gestational diabetes mellitus patients increases significantly in the second trimester, the level of T4 decreases significantly in the third trimester, the positive rate of TPOAb is the highest in the second trimester, and the positive rate of TPOAb decreases in the third trimester, but still at a higher level.