妊娠亚临床甲状腺功能减退患者血清促甲状腺激素、甲状腺过氧化物酶抗体水平与妊娠结局的相关性分析

Correlation between Serum Thyroid Stimulating Hormone and Thyroid Peroxidase Antibody Levels and Pregnancy Outcome in Patients with Subclinical Hypothyroidism in Pregnancy

目的:探究妊娠亚临床甲状腺功能减退患者血清促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPO-Ab)水平与妊娠结局的相关性。方法:选取2019年3月-2020年3月山东省千佛山医院(集团)成武医院收治的200例妊娠亚临床甲状腺功能减退患者作为研究对象,按照是否进行治疗分为治疗组与未治疗组,各100例;按照血清TSH中位数水平高低分为高TSH水平组(115例)与低TSH水平组(85例);按照血清TPO-Ab阳性、阴性分为TPO-Ab阳性组(118例)及TPO-Ab阴性组(82例)。同时选取200例同期来院检查的健康孕妇设为对照组。比较各组不良妊娠结局发生情况。结果:未治疗组早产、妊娠期糖尿病(GDM)、妊娠期高血压、胎儿生长受限、低体重儿发生率高于治疗组及对照组,差异有统计学意义(P<0.05)。高TSH水平组早产、GDM、妊娠期高血压、胎儿生长受限、低体重儿发生率高于低TSH水平组,差异有统计学意义(P<0.05)。TPO-Ab阳性组流产、早产、GDM、妊娠期高血压、胎儿生长受限、低体重儿发生率高于TPO-Ab阴性组,差异有统计学意义(P<0.05)。结论:未经治疗的妊娠亚临床甲状腺功能减退患者、高TSH水平及TPO-Ab阳性者的不良妊娠结局发生风险较高,临床应积极给予干预,预防不良妊娠结局发生。

Objective:To investigate the correlation between serum thyroid stimulating hormone(TSH)and thyroid peroxidase antibody(TPO-Ab)levels and pregnancy outcome in patients with subclinical hypothyroidism in pregnancy.Methods:200 patients with subclinical hypothyroidism in pregnancy admitted to Shandong Provincial Qianfoshan Hospital(Group)Chengwu Hospital from March 2019 to March 2020 were selected as study subjects.The cases were divided into treated and untreated groups according to whether treatment was performed or not,100 cases each.According to the median serum TSH level,they were divided into groups with high TSH level(115 cases)and low TSH level(85 cases);according to the positive and negative serum TPO-Ab,they were divided into the groups with positive TPO-Ab(118 cases)and negative TPO-Ab(82 cases).At the same time,200 healthy pregnant women who came to the hospital for examination at the same time were selected as the control group.The incidence of adverse pregnancy outcomes in each group was compared.Results:The incidence of preterm delivery,gestational diabetes mellitus(GDM),gestational hypertension,fetal growth restriction,and low birth weight was higher in the untreated group than in the treated and control groups,and the difference was statistically significant(P<0.05).The incidence of preterm delivery,GDM,gestational hypertension,fetal growth restriction and low birth weight was higher in the group with high TSH level than in the group with low TSH level,and the difference was statistically significant(P<0.05).The incidence of miscarriage,preterm delivery,GDM,gestational hypertension,fetal growth restriction and low birth weight was higher in the group with positive TPO-Ab than in the group with negative TPO-Ab,and the difference was statistically significant(P<0.05).Conclusion:Untreated patients with subclinical hypothyroidism in pregnancy,high TSH levels and TPO-Ab positivity are at higher risk of adverse pregnancy outcomes,and clinical interventions should be actively provided to prevent the occurrence of adverse pregnancy outcomes.