Hb、TSH在不同妊娠时期甲状腺功能减退孕妇中的表达及其与贫血的关系

Expression of Hb and TSH in Pregnant Women with Hypothyroidism during Different Gestation Periods and Their Relationship with Anemia

目的:探讨血红蛋白(Hb)、促甲状腺激素(TSH)在不同妊娠时期甲状腺功能减退症孕妇中的表达及其与贫血的关系。方法:选取我院2018年10月~2019年10月我院收治的产检诊断为甲状腺功能减退并最终分娩的113例孕妇为观察组,根据首次确诊时间分为妊娠早期组(31例)、妊娠中期组(40例)、妊娠晚期组(42例)。所有孕妇给与左旋甲状腺素治疗,通过Pearson相关性分析不同时期TSH与Hb相关性,采用Logitstic多元回归分析甲状腺功能减退孕妇贫血的影响因素。结果:妊娠早期组、中期组、晚期组TSH水平逐渐升高,Hb水平逐渐降低,比较差异有统计学意义(P<0.05);治疗前TSH水平与Hb水平在妊娠期早期、中期、晚期均呈负相关(r=-0.342,P<0.001,r=-0.337,P<0.001,r=-0.410,P<0.001);妊娠早期组治疗后GGT、ALT、TSH、Hb水平较治疗前变化明显(P<0.05),妊娠中期组治疗后TC、GGT、ALT、TSH、Hb水平较治疗前变化明显(P<0.05),妊娠晚期组治疗后TC、GGT、ALT、TSH、Hb水平较治疗前变化明显(P<0.05);甲状腺功能减退孕妇Hb水平变化的影响因素有体重指数、TSH(P<0.05)。结论:甲状腺功能减退孕妇随着妊娠周期增加,TSH表达水平逐渐升高,Hb表达水平逐渐降低,贫血发生风险增加,体重指数和TSH变化是影响不同妊娠时期甲状腺功能减退孕妇Hb水平的独立危险因素。

Objective:To investigate the expression of hemoglobin(HB)and thyroid stimulating hormone(TSH)in pregnant women with hypothyroidism during different gestation periods and to evaluate their relationship with anemia.Methods:113 pregnant women with hypothyroidism delivered in our hospital from October 2018 to October 2019 were enrolled as observation group;according to the diagnosis time,observation group was further divided into three subgroups,early pregnancy group(n=31),mid pregnancy group(n=40)and late pregnancy group(n=42).All the selected women were treated with levothyroxine.Correlation between TSH and Hb was analyzed by Pearson analysis.Then the factors related to anemia in pregnant women with hypothyroidism were determined by Logitstic regression analysis.Results:Among early pregnancy group,mid pregnancy group and late pregnancy group,TSH levels showed an increasing trend,meanwhile,Hb showed a decreasing trend.TSH level was negatively correlated with Hb level in early,mid and late pregnancy groups before treatment(r=-0.342,P<0.001,r=-0.337,P<0.001,r=-0.410,P<0.001).The levels of GGT,ALT,TSH and Hb within early pregnancy group had significant difference before and after treatment(P<0.05).The levels of TC,GGT,ALT,TSH,and Hb within mid pregnancy group had significant difference before and after treatment(P<0.05).The levels of TC,GGT,ALT,TSH,and Hb within late pregnancy group had significant difference before and after treatment(P<0.05).Factors affecting Hb levels in pregnant women with hypothyroidism include body mass index and TSH(P<0.05).Conclusion:With the increase of gestation weeks,hypothyroidism pregnant women have high risk of anemia with the increase of TSH and decrease of Hb,moreover,body mass index and TSH are independent risk factors influencing Hb level of hypothyroidism pregnant women in different gestation periods.