TSH 标准诊断的妊娠早期亚甲减及 TPO-Ab 阳性对妊娠的影响研究

目的：观察妊娠早期亚甲减及 TPO-Ab 阳性对妊娠的影响。方法：以2014年1月～2015年1月在我院接受治疗的妊娠期早期妇女为观察对象，其中合并亚甲减的孕妇42例，合并 TPO-Ab 阳性的孕妇40例，同时选择40例甲状腺功能正常的孕妇作为对照组。观察对照组与亚甲减和 TPO-Ab 阳性组孕妇妊娠期并发症和新生儿并发症发生率的差异；比较三组新生儿 Aagar 评分的差异。结果：亚甲减组孕妇 FT3水平低于对照组，TSH 水平高于对照组，而两组孕妇的 FT4水平无明显差别；亚临床甲减组胎头下降停滞、胎儿生长受限和胎儿窘迫的发生率明显较对照组高；TPO-Ab 阳性组与对照组孕妇 FT3、FT4和 TSH 水平无明显差别；TPO-Ab 阳性组胎头下降停滞和胎儿窘迫发生率明显较对照组高，差别具有统计学意义；亚甲减组和 TPO-Ab 阳性组1min 和5minApgar 评分明显较对照组低，而亚甲减组和 TPO-Ab 阳性组之间无明显差别。结论：妊娠早期亚甲减及 TPO-Ab 阳性的孕妇，妊娠并发症的发生率较高。

Effect of subclinical hypothyroidism and TPO-Ab positive during early pregnancy on early pregnancy

Objective To observe the effect of subclinical hypothyroidism and TPO-Ab positive during early pregnancy on pregnancy. Methods Pregnant women in our hospital from January 2014 and January 2015 were selected as the object, 42 cases with subclinical hypothyroidism in pregnant women and, 40 cases with TPO AB positive pregnant and 40 cases with normal thyroid function in pregnant women as control group. Women pregnancy complications and neonatal complications in control group and subclinical hypothyroidism, TPO-Ab positive pregnant were occurred; Aagar score were compared between the three groups. Results The level of FT3 in subclinical hypothyroidism group were lower than control group, TSH levels were higher than control group, while the level of FT4 in the two groups had no significant difference. The rate of fetal head stagnation, fetal growth restriction and the rate of fetal distress in subclinical hypothyroidism group decreased more obvious than control group. There was no significant difference in FT3, FT4 and TSH levels between the TPO-Ab positive group and the control group. The rate of fetal head drops stagnation and fetal distress in TPO-Ab positive group were higher than the control group, the difference had statistical significance.1 min and 5 min Apgar score in subclinical hypothyroidism group and TPO-Ab positive group were significantly lower than control group, and the subclinical hypothyroidism group and TPO-Ab positive group had no significant difference. Conclusion The incidence of pregnancy complications in early pregnancy subclinical hypothyroidism and TPO-Ab positive pregnant women is higher.