甲状腺功能指标在不同孕期妊娠期糖尿病和妊娠期高血压疾病中的表达水平及意义

The expression level and significance of thyroid function in gestational diabetes mellitus and hypertension disorders complicating pregnancy during different pregnancies

目的探讨与分析甲状腺功能指标在不同孕期妊娠期糖尿病(GDM)及妊娠期高血压疾病(HDCP)中的表达水平及意义。方法回顾性分析2017年4月至2020年4月潍坊市益都中心医院产科收治的87例GDM患者及80例HDCP患者的临床资料,年龄(27.54±2.30)岁,年龄范围为25~32岁,分别将其纳入到GDM组与HDCP组。另选取同时期85例健康孕妇作为健康组,对比孕早期(孕周≤13周)、孕中期(孕周14~27周)、孕晚期(孕周≥28周)下GDM及HDCP患者的甲状腺功能指标。结果三组纳入者孕中期的促甲状腺激素(TSH)水平均高于孕早期,孕晚期的TSH水平高于孕中期,差异有统计学意义(P<0.05)。孕中期及孕晚期的HDCP组患者TSH值[(2.35±0.60)mIU/L、(2.37±1.09)mIU/L]明显高于GDM组[(2.12±0.64)mIU/L、(2.29±1.04)mIU/L]与健康组[(1.96±0.51)mIU/L、(2.04±0.48)mIU/L],GDM组的TSH值明显高于健康组,差异有统计学意义(P<0.05)。三组纳入者孕中期的游离甲状腺素(FT4)水平均低于孕早期,孕晚期的FT4水平均低于孕中期,差异有统计学意义(P<0.05)。孕中期及孕晚期GDM组患者的FT4值[(7.15±1.62)pmol/L、(7.01±2.11)pmol/L]明显低于HDCP组[(7.32±2.40)pmol/L、(7.16±2.15)pmol/L]与健康组[(8.06±2.16)pmol/L、(7.79±2.47)pmol/L],HDCP组患者的FT4值明显低于健康组,差异有统计学意义(P<0.05)。结论 GDM及HDCP患者中的甲状腺功能指标存在异常表现,以TSH升高及FT4降低为主,且随着孕期的增加,TSH水平升高,FT4水平降低的更加显著。

Objective To investigate and analyze the expression level and significance of thyroid function indexes in gestational diabetes mellitus(GDM)and hypertension disorders complicating pregnancy(HDCP)in different pregnancy periods.Methods Clinical data of 87 patients with GDM and 80 patients with HDCP admitted to the department of Obstetrics of Weifang Yidu Central Hospital from April 2017 to April 2020 were retrospectively analyzed.All patients were included in the GDM group and the HDCP group,with an age of(27.54±2.30)years old,ranging from 25 to 32 years old.In addition,85 healthy pregnant women admitted at the same time were selected as the healthy group to compare the thyroid function indexes of GDM and HDCP patients at the first(≤13 weeks of gestation),the second(14 to 27 weeks of gestation),and the third(≥28 weeks of gestation).Results The thyroid stimulating hormone(TSH)level in the second trimester of the three groups was higher than that in the first trimester,and the TSH level in the third trimester was higher than that in the second trimester,with statistically significant differences(P<0.05).In the second and third trimester of pregnancy,the TSH value of HDCP group[(2.35±0.60)mIU/L and(2.37±1.09)mIU/L]was significantly higher than that of GDM group[(2.12±0.64)mIU/Land(2.29±1.04)mIU/L]and healthy group[(1.96±0.51)mIU/L and(2.04±0.48)mIU/L],and the TSH value of GDM group was significantly higher than that of healthy group,and the differences were statistically significant(P<0.05).The level of free thyroxine(FT4)in the second trimester was lower than that in the first trimester,and the level of FT4 in the third trimester was lower than that in the second trimester,and the differences were statistically significant(P<0.05).FT4 value in GDM group[(7.15±1.62)pmol/L and(7.01±2.11)pmol/L]was significantly lower than that in HDCP group[(7.32±2.40)pmol/L and(7.16±2.15)pmol/L]and healthy group[(8.06±2.16)pmol/L and(7.79±2.47)pmol/L],FT4 value in HDCP group was significantly lower than that in healthy group,and the differences were statistically significant(P<0.05).Conclusion There are abnormal manifestations of thyroid function indexes in patients with GDM and HDCP,mainly with increased TSH and reduced FT4.With the increase in pregnancy,the level of TSH increases and the level of FT4 reduces more significantly.