检测孕妇甲状腺激素对评估胎儿生长状况及指导临床治疗的意义

目的探讨检测妊娠期孕妇甲状腺激素水平对临床评估胎儿生长状况的价值,分析其与胎儿生长发育间的相关性,以此指导临床合理诊治。方法选取2016年1月-2018年12月在上海市闵行区中心医院分娩的148例孕妇作为此次研究对象,分别于妊娠早中晚期,根据甲状腺激素水平(TSH、FT4)对甲状腺激素水平进行分组,分为低位、中位及高位组。分析各等级甲状腺激素水平与胎儿生长发育间相关性。结果低位FT4组胎儿CRL明显小于中位、高位FT4组;而中位组与高位FT4组胎儿CRL比较,t=0.38,P=0.70;三组胎儿出生体重、身长及胎龄相比较,P>0.05。妊娠早期血清TSH与胎儿CRL间呈负相关性(r=-0.24,P=0.02),血清FT4与CRL间呈正相关性(r=0.28,P=0.01);妊娠中期血清TSH与胎儿BPD、HC和AC呈负相关性(P<0.05);妊娠晚期血清FT4与胎儿FL、HC、AC和出生身长呈负相关性(P<0.05)。结论通过检测妊娠早期孕妇甲状腺激素水平可有助于评估胎儿生长发育状况,当孕妇甲状腺激素水平下降时,胎儿生长发育将受到影响;妊娠中晚期孕妇甲状腺激素与胎儿生长发育呈负相关性。早期检测如出现甲状腺激素异常则需及时给予治疗以纠正其甲状腺激素异常,促进胎儿健康生长。

The Detection of Thyroid Stimulating Hormone in Pregnant Women to Evaluate Fetal Growth and Guide Clinical Treatment

OBJECTIVE To investigate the value of detecting thyroid hormone levels in pregnant women for clinical evaluation of fetal growth status, and to analyze the correlation between fetal growth and fetal growth, so as to guide clinical diagnosis and treatment.METHODS 148 pregnant women who were delivered to the hospital from January 2016 to December 2018 were enrolled in this study.The thyroid hormone levels were determined according to thyroid hormone levels(TSH, FT4) in the early, middle and late stages of pregnancy. Grouping, divided into low and medium and high groups. The correlation between thyroid hormone levels and fetal growth and development was analyzed. RESULTS The fetal CRL in the FT4 group was significantly lower than that in the middle and high FT4 groups;while the median group was compared with the high-grade FT4 fetal CRL, t=0.38, P=0.70;three groups of fetuses were born. Body weight, body length and gestational age were compared, P>0.05. There was a negative correlation between serum TSH and fetal CRL in early pregnancy, r=-0.24, P=0.02. There was a positive correlation between serum FT4 and CRL, r=0.28, P=0.01. In the second trimester, there was a negative correlation among serum TSH and fetal BPD, HC, AC, P<0.05. There was a negative correlation between serum FT4 and fetal FL, HC, AC and birth length in late pregnancy, P<0.05. CONCLUSION The detection of thyroid hormone levels in pregnant women could help to evaluate the growth and development of the fetus. When the thyroid hormone level of pregnant women decreased, the growth and development of the fetus would be affected. The thyroid hormone in pregnant women was negatively correlated with fetal growth and development. Early detection of thyroid hormone abnormalities required timely treatment to correct thyroid hormone abnormalities and promote healthy growth of the fetus.