摘要
目的分析妊娠期甲状腺功能异常患者血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平的变化及与母婴结局的关系。方法回顾性分析2019年1月至2020年1月常州市妇幼保健院收治的80例甲状腺功能异常患者的临床资料,根据患者病理类型分为甲亢组、亚甲减组、甲减组、低甲状腺素血症(THP)组,每组20例;另选取同期在常州市妇幼保健院孕检的35例健康女性的孕检资料,作为健康对照组。比较甲亢组、亚甲减组、甲减组、THP组患者及健康对照组研究对象甲状腺激素水平、早产、分娩方式、新生儿体质量及新生儿阿氏(Apgar)评分。结果甲亢组患者血清TSH水平显著低于健康对照组,血清FT4、FT3水平显著高于健康对照组;亚甲减组患者血清TSH水平显著高于健康对照组;甲减组患者血清TSH水平显著高于健康对照组,血清FT4、FT3水平显著低于健康对照组;THP组患者血清FT3、FT4水平低于健康对照组;甲亢组、亚甲减组、甲减组、THP组患者产钳助产、早产、剖宫产占比均显著高于健康对照组,顺产占比低于健康对照组;甲减组、甲亢组患者新生儿体质量显著低于健康对照组(均P<0.05),5组研究对象Apgar评分出生后5、10 min组间比较,差异均无统计学意义(P>0.05)。结论妊娠期甲状腺功能异常可引起孕妇血清FT3、FT4、TSH水平异常,最终影响产妇分娩方式,增加早产的可能性,且妊娠期甲减、甲亢均可在一定程度上影响胎儿生长发育,导致新生儿出生体质量降低。
Objective To analyze the changes of serum thyroid stimulating hormone(TSH),free triiodothyronine(FT3)and free thyroxine(FT4)levels in patients with abnormal thyroid dysfunction during pregnancy and their relationship with maternal and infant outcomes.Methods Retrospectively analysed the clinical datas of 80 cases patients with abnormal thyroid function admitted to Changzhou Maternal and Child Health Hospital from January 2019 to January 2020,they were divided into the hyperthyroidism group,the subhypothyroidism group,the hypothyroidism group and the transient hypothyroxinemia of prematurity(THP)group according to the pathological types of patients,with 20 cases in each group.In addition,the pregnancy examination datas of 35 healthy women who were examined in the Changzhou Maternal and Child Health Hospital during the same period were selected as the healthy control group.The thyroid hormone levels,premature delivery,delivery method,newborn weight,and newborn Apgar score of the subjects in the healthy control group and the patients in the hyperthyroidism group,the subhypothyroidism group,the hypothyroidism group,the THP group were compared.Results The levels of serum TSH of patients in the hyperthyroidism group were significantly lower than those in the healthy control group,and the levels of serum FT4 and FT3 were significantly higher than those in the healthy control group;serum TSH level in the subhypothyroidism group was significantly higher than that in the healthy control group;serum TSH levels in the hypothyroidism group were significantly higher than those in the healthy control group,and serum FT4 and FT3 levels were significantly lower than those in the healthy control group;serum FT3 and FT4 levels in the THP group were lower than those in the healthy control group;the proportion of obstetrical forceps,premature delivery,and cesarean section in the hyperthyroidism group,the subhypothyroidism group,the hypothyroidism group,the THP group was significantly higher than in the healthy control group,and the proportion of normal delivery patients was lower than that in the healthy control group;the newborn weight of the hypothyroid group,the hypothyroidism group were significantly lower than that in the healthy control group(all P<0.05).There was no statistically significant difference in Apgar scores among the 5 groups 5 and 10 minutes after birth(P>0.05).Conclusion Thyroid dysfunction can lead to abnormal levels of serum FT3,FT4 and TSH in pregnant women,which ultimately affects maternal delivery methods and increases the possibility of premature delivery.In addition,hypothyroidism and hyperthyroidism during pregnancy can affect fetal growth and development to a certain extent,leading to the low birth weight of newborn.
作者
魏梓雯
朱海燕
WEI Ziwen;ZHU Haiyan(Laboratory division,Changzhou Maternal and Child Health Hospital,Changzhou,Jiangsu 213004,China;Early Pregnancy Clinic,Changzhou Maternal and Child Health Hospital,Changzhou,Jiangsu 213004,China)
