甲状腺功能减退与妊娠期糖尿病相互影响的研究

Study on influence of hypothyroidism on gestational diabetes mellitus

目的对甲状腺功能减退与妊娠期糖尿病的相互影响进行研究。方法选择2016年1—12月在郑州大学第三附属医院规律产检并分娩的妊娠期糖尿病合并甲减患者232例(A组),妊娠期糖尿病患者268例(B组)、甲减患者198例(C组)。分别对A组和B组、A组和C组的糖代谢、甲状腺功能、肾功能以及三组妊娠结局进行比较。结果 A组在空腹血糖、OGTT2h、肌酐、尿素明显高于B组(P<0.05)。A组在TSH、TPOAb阳性率的比较上明显高于C组(P<0.05)。A组在早产、巨大儿、妊娠期贫血的发病率上明显高于B组(P<0.05)。A组在胎膜早破、巨大儿发病率上明显高于C组(P<0.05)。在妊娠不良结局发生率上,A组明显高于B组、C组(P<0.05)。结论妊娠期甲减可加重糖代谢、肾功能的紊乱,同时妊娠期糖尿病也可加重甲状腺功能紊乱,二者相互影响,增加妊娠不良结局发生率。

Objective To study the interaction between hypothyroidism and gestational diabetes mellitus.Methods From January 2016 to December 2016 totally 232 cases of gestational diabetes mellitus complicated with hypothyroidism(group A),268 cases of gestational diabetes mellitus(group B)and 198 cases of hypothyroidism(group C)were selected.Glucose metabolism,thyroid function,renal function and pregnancy outcomes of group A and group B,group A and group C were compared.Results Fasting blood glucose,OGTT2 h,creatinine and urea in group A were significantly higher than those in group B(P<0.05).The positive rates of TSH and TPOAb in group A were significantly higher than those in group C(P<0.05).The incidence of premature delivery,macrosomia and anemia during pregnancy in group A was significantly higher than that in group B(P<0.05).The incidence of premature rupture of membranes and macrosomia in group A was significantly higher than that in group C(P<0.05).The incidence of adverse pregnancy outcomes in group A was significantly higher than that in group B and group C(P<0.05).Conclusion Pregnancy hypothyroidism can aggravate the disorder of glucose metabolism and renal function,and gestational diabetes mellitus can aggravate the disorder of thyroid function.The two interact and increase the incidence of adverse pregnancy outcomes.