妊娠期糖尿病合并甲状腺功能减退症47例临床分析

目的：观察甲状腺功能减退症（简称甲减）对妊娠期糖尿病患者各项代谢指标的影响。方法回顾性分析2010年1月至2014年1月在该院就诊的妊娠期糖尿病合并甲减孕妇47例，随机选取同期妊娠期糖尿病孕妇74例作为对照，检测两组孕妇的空腹血糖（ FBG）、口服葡萄糖耐量1 h时血糖（1hBG）、口服葡萄糖耐量2 h时血糖（2hBG）、糖化血红蛋白（ HbA1c）、甘油三酯（TG）、胆固醇（TC）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）、载脂蛋白a（Apoa）、载脂蛋白b（Apob）、血清肌酐（Cr）、胰岛素用量等。结果甲减组的TG、TC、LDL-C显著高于对照组（P＜0．05）；FBG、1hBG、2hBG、HbA1c、HDL-C、Apoa、Apob、Cr无显著差别（P＞0．05）；甲减组的胰岛素用量与对照组比较，差异无统计学意义（P＞0．05）。 TSH与TG、TC和LDL成正相关（P＜0．05）。结论临床上应重视妊娠期糖尿病孕妇甲状腺功能及各项代谢指标的筛查并早期干预治疗，减少甲减对脂代谢的影响。

Clinical analysis of 47 cases of Gestational diabetes mellitus with hypothyroidism

Objective To observe the effects of hypothyroidism on various metabolic parameters in patients with gestational diabetes mellitus.Methods Retrospective analysis of 47 cases of Gestational diabetes mellitus with hypothyroidism in The Second Hospital of An-hui Medical University from January 2010 to January 2014,Randomly selected 74 cases of gestational diabetes mellitus as control.The con-centrations of Fasting blood glucose(FBG),Oral glucose tolerance test 1h blood glucose(1hBG),2h blood glucose(2hBG),Glycosylated hemoglobin(HbA1c),Triglycerides(TG),Cholestero(TC),Low-density lipoprotein(LDL-C),High-density lipoprotein(HDL-C),Apoli-poprotein a(Apoa),Apolipoprotein b(Apob),Creatinine(Cr),Insulin dosage were detected and analyzed.Results There were no signif-icant difference between two groups in FBG,1hBG,2hBG,HbA1c,HDL-C,Apoa,Apob,Cr,Insulin dosage(P>0.05),but TG,TC,LDL-C of Hypothyroidism group is significantly higher than the control group(P<0.05).There were Positive correlation between TSH and TG, TC and LDL.Conclusions Clinical doctors should pay attention to screening and early intervention treatment of pregnant women with gestational diabetes mellitus thyroid function and metabolism indexes,reduce the effects of hypothyroidism on lipid metabolism.