甲状腺功能减退症伴重度子痫前期患者的临床特点及对新生儿妊娠结局影响

Clinical characteristics of hypothyroidism with severe preeclampsia and its influence on neonatal pregnancy outcome

目的探讨甲状腺功能减退症伴重度子痫前期患者的临床特点及对新生儿妊娠结局影响。方法选取平顶山市第二人民医院2019年2月至2021年2月收治的80例重度子痫前期患者,将其中42例合并甲状腺功能减退症患者设为A组,38例不合并甲状腺功能减退症患者设为B组,另选取50例同期妊娠合并甲状腺功能减退症患者作为C组,比较三组患者血清促甲状腺素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)水平,24 h尿蛋白定量及血浆白蛋白水平,甲状腺激素水平与各项指标的相关性以及妊娠结局比较。结果三组患者TSH、FT4比较,A组TSH水平高于B组、C组,FT4水平低于B组、C组(P<0.05);A组24 h尿蛋白定量高于B组,血浆白蛋白水平低于B组(P<0.05);甲状腺功能减退症伴重度子痫前期患者24 h尿蛋白定量与TSH水平呈正相关,与FT4呈负相关,与FT3不具有相关性;血浆白蛋白与TSH水平呈负相关,与FT4呈正相关,与FT3不具有相关性;A组、B组早产率高于C组,且A组高于B组(P<0.05);A组、B组剖宫产率高于C组(P<0.05),A组与B组比较,差异无统计学意义(P>0.05),三组胎盘早剥发生率比较,差异无统计学意义(P>0.05)。结论甲状腺功能减退症伴重度子痫前期患者促甲状腺素水平异常,不良妊娠结局发生率较高,临床应加强子痫前期孕妇甲状腺功能的检查。

【Objective】To discuss the clinical characteristics of hypothyroidism with severe preeclampsia and its influence on neonatal pregnancy outcome.【Methods】Eighty patients with severe preeclampsia in our hospital from February 2019 to February 2021 were selected,42 patients with hypothyroidism were set as group A,38 patients without hypothyroidism were set as group B,and 50 cases of simultaneous pregnancy complicated with hypothyroidism were selected as group C.The levels of serum TSH,FT 4,FT 3,24 h urinary protein and plasma albumin,the correlation between thyroid hormone levels and various indicators and pregnancy outcomes were compared among the three groups.【Results】The level of TSH in group A was higher than that in group B and group C,and the level of FT 4 in group A was lower than that in group B and group C(P<0.05).The 24-hour urinary protein in group A was higher than that in group B,and the plasma albumin level in group A was lower than that in group B(P<0.05).In patients with hypothyroidism and severe preeclampsia,24-hour urinary protein was positively correlated with TSH level,negatively correlated with FT 4,but not correlated with FT 3;plasma albumin was negatively correlated with TSH level,positively correlated with FT 4,but no correlated with FT 3.The premature birth rate of group A and group B was higher than that of group C,and it was higher in group A than in group B(P<0.05).The cesarean section rate of group A and group B was higher than that of group C(P<0.05),and there was no significant difference between group A and group B(P>0.05).There was no significant difference in the incidence of placental abruption among the three groups(P>0.05).【Conclusion】Patients with hypothyroidism complicated with severe preeclampsia have abnormal thyroid stimulating hormone levels and a high incidence of adverse pregnancy outcomes,so clinical examination of thyroid function of preeclampsia pregnant women should be strengthened.