亚临床甲状腺功能减退合并妊娠期高血压对母婴结局的影响

目的]探讨亚临床甲状腺功能减退(SCH)合并妊娠期高血压对母婴结局的影响.方法] 选取2014年5月至2016年3月本院收治的90例SCH妊娠期患者,依据妊娠25～28周时测定的血压将患者分为合并组48例(SCH合并妊娠期高血压)及未合并组42例(SCH未合并高血压),另外选取同期本院产检的健康志愿者40例(健康组),比较三组甲状腺功能指标促甲状腺激素(TSH)、甲状腺激素(FT4)、甲状腺过氧化物酶抗体(TPO-Ab)]、血脂水平三酰甘油(TG)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDLC)]、母婴结局及妊娠并发症发生率.结果] 合并组TSH、TPO-Ab表达水平较未合并组、健康组明显增高,FT4降低,合并组TG、TC、LDLC表达水平最高,未合并组次之,健康组最低,组间两两比较有统计学意义(P<0.05);合并组母婴不良结局总发生率47.92％及妊娠并发症总发生率31.25％最高,未合并组次之(16.67％、11.90％),健康组最低(2.50％、0.00％),组间两两比较差异有统计学意义(P<0.05).结论]SCH与妊娠期高血压密切相关,考虑可能与血脂代谢异常有关,SCH合并妊娠期高血压患者的不良母婴结局总发生率较单一疾病及健康孕产妇明显增高.

Effect of Subclinical Hypothyroidism with Gestational Hypertension on Maternal and Neonatal Outcomes

Objective]To investigate the effect of subclinical hypothyroidism (SCH) and gestational hypertension on maternal and neonatal outcomes.Methods] A total of 90 patients with gestational SCH treated in the hospital from May 2014 to March 2016 and 40 healthy volunteers (the healthy group) who received antenatal care in the same period were selected as subjects.According to the blood pressure measured after 25～28 weeks of pregnancy, the patients with gestational SCH were divided into the combined group (48 cases of SCH with gestational hypertension) and the control group (42 cases of SCH without hypertension).The thyroid function thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibody (TPO-Ab)], blood lipid levels triglyceride (TG), serum total cholesterol (TC), low-density lipoprotein (LDLC)], maternal and neonatal outcomes, and the incidence of pregnancy complications were compared among the three groups.Results] The levels of TSH and TPO-Ab in the combined group were significantly higher than those in both the control group and the healthy group, while FT4 was lower.The levels of TG, TC and LDLC were the highest in the combined group and followed by the control group, and those in the healthy group were the lowest.There were significant differences between any two groups (P<0.05).The total incidence of adverse maternal and neonatal outcomes, and pregnancy complications in the combined group were the highest (47.92％, 31.25％), followed by the control group (16.67％, 11.90％), and the incidence was lowest in the healthy group (2.50％, 0.00％).There were significant differences between any two groups (P<0.05).Conclusion] SCH is closely related to pregnancy-induced hypertension, which may be related to abnormal lipid metabolism.The total incidence of adverse maternal and neonatal outcomes in patients with SCH complicated with pregnancy-induced hypertension is significantly higher than that in pregnant women with single disease or healthy pregnant women.