妊娠期单纯低甲状腺素血症与糖脂代谢及胎儿生长发育的相关性分析

目的探讨妊娠中晚期单纯低甲状腺素血症对孕妇血糖、血脂和胎儿生长发育的影响。方法收集2018年1月至2020年6月分娩孕妇的甲状腺功能检测结果,按妊娠期特异性参考值范围,筛选出单纯低甲状腺素血症患者为观察组,根据检测孕周分为孕中期组和孕晚期组,并随机选择同期甲状腺功能正常健康孕妇为对照组,比较各组孕妇糖、脂代谢指标(血糖、甘油三酯和胆固醇)、孕妇体重指数(孕前BMI、产前BMI和孕期BMI增加)、妊娠结局(妊娠期糖尿病、妊娠期高血压、子痫前期、早产、低出生体重儿和巨大儿的发生率)及胎儿生长发育指标(头围、腹围、出生体重、出生BMI)的差异。结果孕中期组和孕晚期组血糖、甘油三脂比对照组升高;孕中期组和孕晚期组孕妇的孕前BMI、产前BMI及孕期BMI增加均比对照组增加;孕中期组妊娠期糖尿病的发生率较比照组升高;各组间胎儿生长指标差异无统计学意义。结论妊娠期单纯低甲状腺素血症可引起患者糖、脂代谢紊乱,主要表现在血糖和甘油三脂升高;肥胖孕妇易出现单纯低甲状腺素血症。

Objective To investigate the effects of isolate hypothyroidism in the middle and third trimnester of pregnancy on glucolipid metabolism and fetal growth.Methods The thyroid function test results of antenatal care and childbirth pregnant women were collected in our hospital obstetric from January 2018 to June 2020.According to established pregnancy specific reference range of our hospital,pregnant women with low thyroid hormone levels were selected as experimental group.According to their detect gestational week,they were divided into mid pregnancy and late pregnancy group,healthy pregnant women with normal thyroid function were selected as the control group.The groups of pregnant women metabolic indicators(blood glucose,triglyceide,and cholesterol),pregnant women body mass index(progestational BMI,prenatal BMI and increased BMI during pregnancy),the pregnancy outcome(the incidence of gestational diabetes,gestational hypertension,preeclampsia,premature birth,low birth weight and macrosomia)and fetal growth index(head circumference,abdomen circumference,birth weight and birth BMI)were compared.Results Blood glucose and triglyceride in the mid pregnancy and late pregnancy groups were higher than those in the control group.The progestational BMI,prenatal BMI and increased BMI during pregnancy in the mid pregnancy and late pregnancy groups were significantly higher than that in the control group.The incidence of gestational diabetes in the mid pregnancy group was significantly higher than that in the control group.There was no statistic aly signifcant difference in fetal growth index between the groups.Conclusion Isolate hypothyroidism during pregnancy can cause the disorder of glucolipid metabolism in patients,mainly manifested by the increase of blood glucose and triglyceride.Obese pregnant women are prone to isolate hypothyroidism.