妊娠期糖尿病孕妇甲状腺功能指标与妊娠结局

The relationship between the levels of thyroid function indicators of women with gestational diabetes mellitus and their pregnancy outcomes

目的:探讨妊娠期糖尿病(GDM)患者血清抗甲状腺球蛋白抗体(TGAb)、抗甲状腺过氧化物酶抗体(TPOAb)、促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT3)等水平及意义。方法:2015年3月—2018年6月在本院治疗的GDM患者200例(GDM组),选取同期健康产妇200例为对照组,检测两组分娩前TGAb、TPOAb、TSH、FT3、游离甲状腺素(FT4)、三碘甲状腺原氨酸(T3)和甲状腺素(T4)水平。结果:两组TSH、T3、T4、FT3水平比较无差异(P>0.05);GDM组FT4(5.01±1.01pmol/L)低于对照组,TGAb阳性率、TPOAb阳性率、TGAb+TPOAb阳性率(14.0%、10.5%和9.0%)高于对照组(均P<0.05);GDM组妊娠结局不良与结局正常者血清TSH、T3、T4、FT3、FT4水平比较无差异(P<0.05);GDM组不良妊娠结局者TGAb阳性率、TPOAb阳性率、TGAb+TPOAb阳性率(23.1%、16.9%和16.9%)均高于正常妊娠结局者(P<0.05)。结论:GDM患者血清TGAb、TPOAb、FT4处于异常状态,对妊娠结局可能有一定影响作用。

Objective:To investigate the levels and significance of levels of serum anti thyroglobulin antibody(TGAb),anti thyroid peroxidase antibody(TPOAb),thyrotropin(TSH),free triiodothyronine(FT3),free thyroxine(FT4),triiodothyronine(T3)and thyroxine(T4)of women with gestational diabetes mellitus(GDM).Methods:200 pregnant women with GDM were selected in GDM group and 200 healthy pregnant women were selected in control group from March 2015 to June 2018.The levels of TGAb,TPOAb,TSH,FT3,T3,T4,and FT4 of all included women were measured before delivery.Results:There were no significant difference in levels of TSH,T3,T4 and FT3 of women between the two group(p>0.05).The FT4 level of women in GDM group was(5.01±1.01)pmol/L,which was significant lower than that of women in the control group(P<0.05).The positive rates of TGAb,TPOAb,TGAb+TPOAb of women in GDM group were 14.0%,10.5%and 9.0%,respectively,which were significant higher than those of women in the control group(P<0.05).In GDM group,there were no significant difference in levels of serum TSH,T3,T4,FT3 and FT4 between women with adverse pregnancy outcomes and women with normal pregnancy outcomes(P<0.05),and the positive rates of TGAb,TPOAb,TGAb+TPOAb of women with adverse pregnancy outcomes were 23.1%,16.9%and 16.9%,respectively,which were significant higher than those of women with normal pregnancy outcomes(P<0.05).Conclusion:The levels of serum TGAb,TPOAb and FT4 of pregnant women with GDM are abnormal,which maybe have some adverse influence on pregnancy outcomes.