探讨妊娠期亚临床甲状腺血清学指标异常患者甲状腺超声表现

To investigate the ultrasonographic manifestations of thyroid in patients with abnormal subclinical thyroid serological indexes during pregnancy

目的:探讨妊娠期亚临床甲状腺血清学指标异常患者甲状腺超声表现。方法:选取2021年1月—12月张家港市第一人民医院收治的60例妊娠期亚临床甲状腺血清学指标异常患者,根据血清游离甲状腺素(free thyroxine,FT4)、血清促甲状腺激素(thyroid stimulating hormone,TSH)、抗甲状腺过氧化物酶抗体(anti-thyroid peroxidase antibody,A-TPoAb)等甲状腺血清学指标水平检测结果分为亚临床甲状腺功能亢进组(26例)、亚临床甲状腺功能减低组(22例)、单纯TPoAb水平增高组(12例),均行甲状腺超声诊断,对比三组甲状腺实质回声、甲状腺腺体内部血流分布等超声表现特征。结果:甲状腺功能亢进组、A-TPoAb水平增高组患者甲状腺实质回声超声表现以0度为主,甲状腺功能减低组患者甲状腺实质回声超声表现为0度、1度差异不大,三组患者各度甲状腺实质回声超声表现差异均有统计学意义(P<0.05);三组患者甲状腺腺体内部血流分布的超声表现均以1级为主,高于2级、3级,亚临床甲状腺功能亢进组、TPoAb水平增高组2级、3级对比差异不显著,甲状腺功能减低组2级高于3级,三组患者甲状腺腺体内部血流分布超声表现差异无统计学意义(P>0.05)。结论:不同类型妊娠期亚临床甲状腺血清学指标异常患者甲状腺超声表现并不完全一致,临床对孕妇妊娠期甲状腺功能需要综合评价。

Objective To investigate the ultrasonographic features of thyroid in patients with abnormal subclinical thyroid serological indexes during pregnancy.Methods Selected 60 patients with abnormal subclinical thyroid serological indexes during pregnancy who were admitted to Zhangjiagang First People's Hospital from January to December 2021.Anti-Thyroid peroxidase antibody(A-TPoAb)and other thyroid serological indexes were divided into subclinical hyperthyroidism group(26 cases),subclinical hypothyroidism group(22 cases),and pure A-TPoAb level increased group(12 cases),all patients underwent thyroid ultrasound diagnosis,and the ultrasound features such as thyroid parenchyma echo and internal blood flow distribution in the thyroid gland were compared among the three groups.Results The ultrasound performance of parenchymal echosound in patients with hyperthyroidism group and increased A-TPoAb level was mainly 0 degree,the performance of parenchymal echosound in patients in the hypothyroid group was 0 degree and 1 degree,and the difference in thyroid parenchymal echosound ultrasound performance between patients in the three groups was statistically significant(P<0.05);the ultrasound performance of blood flow distribution inside thyroid glands in the three groups was mainly grade 1,higher than grade 2 and grade 3,the difference of the comparison of the subclinical hyperthyroidism group and TPoAb level increase group in grade 2 and grade 3 was not significant,grade 2 was higher than grade 3 in the hypothyroidism group,and there was no significant difference in ultrasound performance of blood flow distribution inside thyroid glands in the three groups(P>0.05).Conclusion Thyroid ultrasound findings in patients with different types of subclinical thyroid serological abnormalities during pregnancy are not completely consistent.Clinical evaluation of thyroid function in pregnant women during pregnancy needs comprehensive evaluation.