妊娠合并甲状腺功能减退患者血清TSH、叶酸、Hcy表达水平及其临床意义

Expression levels and clinical significance of serum TSH, folic acid and Hcy in pregnancy patients complicated with hypothyroidism

目的探讨妊娠合并甲状腺功能减退患者血清促甲状腺激素(TSH)、叶酸(FA)、同型半胱氨酸(Hcy)表达水平及其临床意义。方法纳入2018年1月至2019年12月间山东第一医科大学附属青岛医院收治的76例妊娠期甲状腺功能减退患者(观察组)作为研究对象,并选取同期体检的50例甲状腺功能正常者妊娠妇女作为对照组。比较两组血清TSH、FA、Hcy表达水平,分析母婴结局与TSH、FA、Hcy的关系。结果 (1)观察组与对照组、控制组与未控制组、不良妊娠结局组与正常妊娠结局组TSH、Hcy、FA差异均有统计学意义(P <0.05);(2) TSH、Hcy均与FA呈负相关关系(P <0.05),Hcy与TSH呈正相关关系(P <0.05);(3)控制组胎儿窘迫及总不良事件发生率均低于未控制组(P <0.05),控制组不良事件发生率与对照组比较差异无统计学意义(P>0.05)。结论妊娠合并甲减患者出现TSH、Hcy、FA变化,监测三指标水平能为甲减诊治和预测患者预后提供信息。

Objective To investigate the expression levels and clinical significance of serum thyroid stimulating hormone(TSH), folic acid(FA) and homocysteine(Hcy) in pregnancy patients complicated with hypothyroidism.Methods 76 pregnancy patients complicated with hypothyroidism, who admitted from January 2018 to December 2019 in Qingdao Affiliated Hospital of Shandong First Medical University, were included as the observation group, and 50 pregnant women with normal thyroid function were selected as control group.The expression levels of serum TSH, FA and Hcy were compared, and the relationship between maternal-infant outcomes with TSH, FA and Hcy were analyzed.Results(1) There were statistically significant differences in the TSH, Hcy, and FA between observation group and control group, controlled group and uncontrolled group, poor pregnancy outcome group and normal pregnancy outcome group(P < 0.05).(2) The level of TSH and Hcy were negatively correlated with FA(P < 0.05), and Hcy was positively correlated with TSH(P < 0.05).(3) The incidence rates of fetal distress and total adverse events in controlled group were lower than those in uncontrolled group(P < 0.05).There were no statistically significant differences in the incidence rates of adverse events between controlled group and control group(P > 0.05).Conclusions The changes of TSH, Hcy and FA appear in pregnancy patients complicated with hypothyroidism.Monitoring the three indexes can provide information for diagnosis and treatment of hypothyroidism and prediction of prognosis.