妊娠期高血压疾病与甲状腺功能异常的临床研究

目的探讨妊娠期高血压疾病与妊娠晚期甲状腺功能异常的关系。方法选择2012年1月至2012年12月足月分娩的妊娠期高血压疾病患者326例作为研究组,其中妊娠期高血压133例,轻度子痫前期92例,重度子痫前期101例;同期201例正常妊娠孕妇为正常组。采用电化学发光技术进行血清甲状腺功能检测,比较两组甲状腺功能及孕妇合并甲状腺疾病情况。结果研究组患者血清促甲状腺激素水平TSH,2.78mU/L（0.71~7.37mU/L）]与正常组2.35mU/L（0.79~4.52mU/L）]比较,差异有统计学意义（P〈0.001）,研究组游离甲状腺素水平FT4,12.13pmol/L（8.96~17.12pmol/L）]与正常组12.80pmol/L（8.69~17.76pmol/L）]比较,差异有统计学意义（P〈0.001）,研究组甲状腺过氧化物酶抗体水平TPO-Ab,19.06U/ml（5.00~78.35U/ml）]与正常组18.58U/ml（5.00~49.98U/ml）]比较,差异无统计学意义（P〉0.005）;妊娠期高血压疾病严重程度与TSH呈正相关（r=0.122,P〈0.05）,与FT4和TPO-Ab水平无关（r分别为0.005和0.030,P均〉0.05）。研究组总甲状腺功能异常发生率（15.34%,50/326）与正常组（8.46%,17/201）比较,差异有统计学意义（χ2=5.303,P〈0.05）,其中子痫前期组甲状腺功能减退的发生率（4.35%,4/92）与正常组（4.95%,5/101）比较,差异有统计学意义（P〈0.05）。结论妊娠期高血压疾病与甲状腺功能异常密切相关。

Clinical study of hypertensive disorders complicating pregnancy and thyroid dysfunction

Objective The aim of the study is to detect the relationship between hypertensive disorders complicating pregnancy （HDCP） and thyroid dynfunction in the third trimester of pregnancy. Methods From Jan uary to December 2012, fullterm pregnant women as the research objects were tested serum thyroid function. 326 cases with HDCP were as study group, of which 133 cases were gestational hypertension group, 92 cases with mild preeclampsia and 101 women were severe preeclampsia. 201 normal pregnant women were as control group. The difference of serum thyroid function and the difference of the prevalence rate of thyroid diseases were compared. Results Compared with the normal group, serum thyroid stimulating hormone （TSH） increased significantly （P〈 0. 001） and free thyroxine （FT4） was significantly decreased （P〈0. 001） in the study group. The thyroid peroxidase antibodies （TPO- Ab） level higher in the study group, but the difference had no statistically significant （P〉0. 05）. TSH and the severity of HDCP were positive related （r=0. 122, P〈0.05）, and FT4, TPO- Ab levels had no significant correlation （P〉0. 05）. Compared with the normal group, the incidence of hypothyroidism in HDCP group was significantly increased （P〈0.05）. Conclusion HDCP was closely related with thyroid dynfunction, es- pecially subclinical hypothyroidism.