双胎妊娠孕妇促甲状腺激素水平变化临床分析

目的：检测双胎孕妇的甲状腺激素水平，分析其与双胎并发症的关系。方法：选取2016年6月-2017年1月南京医科大学附属妇产医院待产的136例双胎妊娠孕妇，分为双胎有并发症组（92例）和双胎无并发症组（44例），另选择同期正常单胎妊娠孕妇（50例）做为对照（正常单胎组）。比较3组之间促甲状腺激素（TSH）、血清游离甲状腺素（FT4）水平的差异。采用受试者工作特征（ROC）曲线计算TSH预测双胎妊娠发生并发症的cut-off值。结果：双胎有并发症组TSH水平较双胎无并发症组和正常单胎组明显增高，差异有统计学意义（P＜0.05）；双胎无并发症组TSH水平与正常单胎组相比，差异无统计学意义（P＞0.05）；3组间FT4水平比较，差异均无统计学意义（P＞0.05）。当TSH的cut-off值为5.18 mIU/L时，其预测双胎妊娠发生并发症的敏感度及特异度分别为63%、91%。结论：双胎妊娠有并发症孕妇血清TSH水平升高，检测TSH对双胎妊娠并发症的发生具有很高的预测价值。

Clinical Analysis of TSH Variation in Twin Pregnancy

Objective: Detect thyroid level of twin pregnancies, to analyze the relationship between pregnancy complications and thyroid level. Methods: Select 136 women with twin pregnancies who were enrolled in Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University from June 2016 to January 2017. These pregnant women were classified into two groups:one with complicated pregnancy (92 cases), the other with uncomplicated pregnancy (44 cases). The control group consisted of 50 normally single pregnant women. Compare thyroid stimulating hormone (TSH) and serum free thyroxine (FT4) between these three groups. Calculate the cut-off value of TSH in predicting complications of twin pregnancy with the ROC (receiver operating characteristics) curve. Results:TSH level in group of twin pregnancy women with complications was obviously high compared with the other groups, the difference was statistically significant (P<0.05);There was no statistical difference between TSH level in uncomplicated group and that in normally single pregnancy group (P>0.05). There were no statistical differences between FT4 in these three groups (P>0.05). When the cut-off value of TSH was 5.18 mIU/L,the susceptibility and specificity was 63%and 91%respectively. Conclusions:TSH level increased in twin pregnancy women with complications. To detect TSH level has a high value of predicting the complications in twin pregnancy women.