妊娠期亚临床甲减患者临床特点及对母婴结局的影响分析

Clinical Characteristics of Patients with Subclinical Hypothyroidism During Pregnancy and Its Influence on Maternal and Neonatal Outcomes

目的观察并分析妊娠期亚临床甲状腺功能减退患者的临床特点以及对母婴结局的影响。方法将160例妊娠期亚临床甲减患者纳入研究样本,依据随机原则以及患者自身治疗意愿,将其分为接收左甲状腺素钠治疗的治疗组(n=82例)与不接受治疗的对照组(n=78例)。比较两组治疗前后的血清游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)以及促甲状腺激素(TSH)水平,并比较所有研究对象的母婴结局。结果治疗组治疗后的血清FT3、FT4水平较治疗前有明显升高(P<0.05),与对照组相比差异有统计学意义(P<0.05);治疗组治疗后的TSH水平较治疗前与对照组均显著降低(P<0.05);治疗组产妇自然分娩率(85.37%)显著高于对照组(52.56%),差异有统计学意义(P<0.05);治疗组产妇的总不良结局发生率显著低于对照组(P<0.05);治疗组的新生儿总不良结局发生率显著低于对照组(P<0.05)。结论妊娠期亚临床甲状腺功能减退患者临床特点为TSH异常升高而FT3、FT4水平较为正常,及时药物干预可显著降低产妇与新生儿的不良结局发生率。

Objective To observe and analyze the clinical characteristics of patients with subclinical hypothyroidism during pregnancy and the effect on maternal and neonatal outcomes.Methods A total of 160 patients with subclinical hypothyroidism during pregnancy who were admitted to the hospital were enrolled in the study.According to the random principle and the patient’s intention of treatment,the subjects were divided into the treatment group(treated with levothyroxine sodium,n=82)and the control group(without treatment,n=78).Levels of serum free triiodothyronine(FT3),serum free thyroxine(FT4),and thyroid stimulating hormone(TSH)were compared between the two groups before and after treatment,and the maternal and neonatal outcomes of all subjects were compared.Results The levels of serum FT3 and FT4 in the treatment group were significantly increased after treatment(P<0.05),and there were statistically significant differences,compared with the control group(P<0.05).The TSH level in the treatment group after treatment was significantly lower than that before treatment and that in the control group(P<0.05).The natural delivery rate of the treatment group(85.37%)was significantly higher than that of the control group(52.56%)(P<0.05).The total incidence rates of adverse maternal and neonataloutcomes in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion The clinical characteristics of patients with subclinical hypothyroidism during pregnancy include abnormally elevated TSH levels and normal FT3 and FT4 levels.Timely drug intervention can significantly reduce the incidence of adverse maternal and neonataloutcomes.