妊娠期甲状腺功能异常与妊娠期糖尿病、高血压的患病风险分析

Analysis on the Risk of Thyroid Dysfunction and Gestational Diabetes and Hypertension

目的分析妊娠期甲状腺功能异常患者妊娠期糖尿病、高血压的患病风险。方法选取2018年1月-2019年6月无棣县水湾中心卫生院收治的225例妊娠期甲状腺功能异常患者作为研究对象,按照甲状腺功能异常类型分为甲亢组(31例)、甲减组(88例)、亚临床甲减组(106例),另选取同期于我院接受产检的200例健康体检者作为对照组,检测各组研究对象的血糖、血压指标,并统计各组妊娠期糖尿病、高血压的患病情况,进行对比分析。结果甲减组、亚临床甲减组空腹血糖、餐后2h血糖、糖化血红蛋白、收缩压、舒张压显著高于甲亢组和对照组(P<0.05)。四组妊娠期糖尿病患病率由低到高分别为:对照组<甲亢组<甲减组<亚临床甲减组,任意两组对比差异均有统计学意义(P<0.05);高血压患病率由低到高分别为:对照组<甲亢组<亚临床甲减组<甲减组,任意两组对比差异均有统计学意义(P<0.05)。结论妊娠期甲状腺功能异常会增加妊娠期糖尿病、高血压的患病风险,其中甲减、亚临床甲减患者发生风险尤其高。

OBJECTIVE To analyze the risk of gestational diabetes and hypertension in patients with thyroid dysfunction during pregnancy. METHODS From January 2018 to June 2019, 225 patients with thyroid dysfunction during pregnancy were selected as the study objects. According to the types of thyroid dysfunction, the patients were divided into hyperthyroidism group(31 cases), hypothyroidism group(88 cases) and subclinical hypothyroidism group(106 cases). In addition, 200 physical examinees in target hospital during the same period were selected as the control group to measure the blood glucose and blood pressure. The prevalence of gestational diabetes mellitus and hypertension in each group were compared and analyzed. RESULTS The fasting blood glucose, 2 hours postprandial blood glucose, HbA1c, SBP and DBP of hypothyroidism group and subclinical hypothyroidism group were significantly higher than hyperthyroidism group and control group(P<0.05). The prevalence of gestational diabetes in the four groups ranked in ascending order(from the lowest to the highest) were as follows: control group, hyperthyroidism group, hypothyroidism group and subclinical hypothyroidism group. The differences between any two groups were statistically significant(P<0.05). The prevalence of hypertension ranked in ascending order(from the lowest to the highest) were as follows: control group, hyperthyroidism group, subclinical hypothyroidism group and hypothyroidism group. The differences between any two groups were statistically significant(P<0.05). CONCLUSION Abnormal thyroid function during pregnancy would increase the risk of gestational diabetes and hypertension. The risks of hypothyroidism and subclinical hypothyroidism were especially high.