妊娠期甲状腺功能减退症孕妇不同时期治疗效果及妊娠结局

目的:探究妊娠期甲状腺功能减退症孕妇不同时期治疗效果及血清促甲状腺激素(TSH)、游离甲状腺激素(FT4)、甲状腺过氧化物酶抗体(TPOAb)水平和妊娠结局。方法:2017年6月30日-2018年5月30日本院产前检查孕妇中筛选患有甲状腺功能减退症者120例,选择60例为一般给药组,在孕8周前行L-T4替代治疗;60例为推迟给药组,在孕8周后行L-T4替代治疗;另选同期产前健康健康孕妇60例为对照组。检测不同妊娠期TSH、FT4、TT4及TPOAb水平。统计围生期结局。结果:治疗前,一般给药组与推迟给药组血清TSH、FT4、TT4及TPOAb水平与对照组存在差异(P<0.05),治疗后在孕30周时两给药组血清上述指标与对照组无差异(P>0.05)。一般给药组自然流产、妊娠期糖尿病、胎盘早剥比例低于延迟给药组(P<0.05),但与对照组没有差异(P>0.05);妊娠期高血压、低出生体重儿两给药组及与对照组均无差异(P>0.05);一般给药组子代6月龄、12月龄时Gesell量表评分高于推迟给药组(P<0.05),与对照组无差异(P>0.05)。结论:对甲状腺功能减退症孕妇妊娠早期及早干预,可有效降低围产期不良结局发生几率,保证新生儿的早期发育。

Therapeutic effect at different stages of pregnant women with hypothyroidism and their pregnancy outcomes

Objective:To explore the therapeutic effect at different stages of pregnant women with hypothyroidism,and to study their serum thyroid stimulating hormone(TSH),FT4,Thyroid peroxidase antibody(TPOAb)levels,and their pregnancy outcomes.Methods:120 pregnant women with hypothyroidism were selected and were divided into group A(60 women with L-T4 treatment before 8 gestational weeks)and group B(60 women with L-T4 treatment after 8 gestational weeks)from 30 June 2017 to 30 May 2018.Another 60 healthy pregnant women were randomly selected in group C during the same time.The levels of TSH,FT4,TT4 and TPOAb of women in the three groups during different stages of pregnancy were detected.Results:Before treatment,the serum TSH,FT4,TT4 and TPOAb levels of women in group A and group B were significant different from those of women in group C(P<0.05).After treatment,the serum TSH,FT4,TT4 and TPOAb levels of women in group A and group B during 30 gestational weeks had no significant different from those of women in group C(P>0.05).The proportions of spontaneous abortion,gestational diabetes mellitus,and placental abruption of women in group A were significant lower than those of women in group B(P<0.05),but those of women in group A had no significant different from those of women in group C(P>0.05).There were no significant differences in the rates of gestational hypertension and low birth weight of women between group A and B and group C(P>0.05).Gesell scale scores of the babies of the women in group A at 6 months and 12 months old were significant higher than those of babies of women in group B(P<0.05),but which had no significant difference between group A and group C(P>0.05).Conclusion:Intervention for pregnant women with hypothyroidism early can reduce the incidence of adverse perinatal outcomes effectively and can ensure the early development of newborns.