[1]李恩芳.妊娠早期亚临床型甲状腺功能减退症对妊娠结局的影响及药物治疗效果[J].新乡医学院学报,2018,35(5):404-406.[doi:10.7683/xxyxyxb.2018.05.012]
　LI En-fang.Effect of subclinical hypothyroidism in early pregnancy on the pregnancy outcome and the effect of drug intervention[J].Journal of Xinxiang Medical University,2018,35(5):404-406.[doi:10.7683/xxyxyxb.2018.05.012]
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妊娠早期亚临床型甲状腺功能减退症对妊娠结局的影响及药物治疗效果
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年5
页码:
404-406
栏目:
临床研究
出版日期:
2018-05-05

文章信息/Info

Title:
Effect of subclinical hypothyroidism in early pregnancy on the pregnancy outcome and the effect of drug intervention
作者:
李恩芳
（南京大学医学院附属泰康仙林鼓楼医院妇产科，江苏　南京　210046）
Author(s):
LI En-fang
（Department of Gynaecology and Obstetrics，Taikang Xianlin Drum Tower Hospital Affiliated to the Medical School of Nanjing University，Nanjing 210046，Jiangsu Province，China）
关键词:
亚临床型甲状腺功能减退症; 妊娠; 妊娠结局; 左甲状腺素
Keywords:
subclinical hypothyroidism; pregnancy; pregnancy outcome; levothyroxine
分类号:
R714.256
DOI:
10.7683/xxyxyxb.2018.05.012
文献标志码:
A
摘要:
目的　探讨妊娠早期亚临床型甲状腺功能减退症（SCH）对妊娠结局的影响及药物治疗效果。方法　选择2015年10月至2017年1月南京大学医学院附属泰康仙林鼓楼医院收治的妊娠早期SCH患者151例，其中拒绝药物治疗者93例（未治疗组），接受左甲状腺素治疗者58例（治疗组）。另选择甲状腺功能正常的健康孕妇200例为正常对照组。追踪随访3组孕妇的妊娠结局及产科并发症发生情况，并进行比较。结果　未治疗组SCH孕妇妊娠期糖尿病、胎儿生长受限、自发性流产、早产及出生低体质量儿发生率显著高于正常对照组（χ2=11.876、13.129、15.003、10.073、9.569，P<0.05）；未治疗组与正常对照组孕妇妊娠高血压及胎盘早剥发生率比较差异无统计学意义（χ2=5.435、6.562，P>0.05）。治疗组SCH孕妇妊娠期糖尿病、胎儿生长受限、自发性流产及早产发生率显著低于未治疗组（χ2=10.112、9.572、8.652、7.356，P<0.05）；治疗组与未治疗组SCH孕妇妊娠高血压、胎盘早剥及出生低体质量儿发生率比较差异无统计学意义（χ2=5.003、3.211、7.023，P>0.05）。治疗组与正常对照组孕妇妊娠期糖尿病、妊娠高血压、胎儿生长受限、胎盘早剥、自发性流产、早产及出生低体质量儿发生率比较差异均无统计学意义（χ2=3.015、3.026、5.137、5.189、5.201、2.190、4.201，P>0.05）。结论　SCH可导致孕妇妊娠期并发症和不良妊娠结局，左甲状腺素可以显著降低妊娠期并发症，改善妊娠结局。
Abstract:
Objective　To investigate the effect of subclinical hypothyroidism（SCH） in early pregnancy on the pregnancy outcome and the effect of drug intervention.Methods　A total of 151 pregnant women with SCH were selected from October 2015 to January 2017 in Taikang Xianlin Drum Tower Hospital Affiliated to the Medical School of Nanjing University.Among the patients，93 patients rejected drug therapy （non-treatment group），and 58 patients were treated with levothyroxine （treatment group）.A total of 200 healthy pregnant women with normal thyroid function were selected as the normal control group.The pregnancy outcome and obstetric complications of the pregnant women were followed up and compared in the three groups.Results　The incidences of gestational diabetes mellitus，fetal growth restriction，spontaneous abortion，preterm delivery and low-birth-weight infants of pregnant women with SCH in the non-treatment group were significantly higher than those in the normal control group （χ2=11.876，13.129，15.003，10.073，9.569；P<0.05）.There was no significant difference in the incidences of gestational hypertension and placental abruption between the non-treatment group and normal control group （χ2=5.435，6.562；P>0.05）.The incidences of gestational diabetes mellitus，fetal growth restriction，spontaneous abortion and preterm labor of pregnant women with SCH in the treatment group were significantly lower than those in the non-treatment group（χ2=10.112，9.572，8.652，7.356；P<0.05）.There was no significant difference in the incidences of gestational hypertension，placental abruption and low-birth-weight infants between the treatment group and non-treatment group（χ2=5.003，3.211，7.023；P>0.05）.There was no significant difference in the incidences of gestational diabetes mellitus，gestational hypertension，fetal growth restriction，placental abruption，spontaneous abortion，preterm labor and low-birth-weight infants between the treatment group and normal control group （χ2=3.015，3.026，5.137，5.189，5.201，2.190，4.201；P>0.05）.Conclusion　SCH can lead to pregnancy complications and adverse pregnancy outcome in pregnant women.Levothyroxine can significantly reduce pregnancy complications and improve pregnancy outcome.

参考文献/References:

［1］　ATA.Guideline of ATA for the diagnosis and management of thyroid diseases during pregnancy and postpartum［J］.Thyroid，2011，21（10）：1081-1125.
［2］　中华医学会内分泌学分会，中华医学会围产医学分会.妊娠和产后甲状腺疾病诊治指南［J］.中华内分泌代谢杂志，2012，28（2）：354-371.
［3］　李春仙，陈敏，王峰，等.妊娠早期甲状腺功能异常和自身抗体筛查的研究［J］.中华内分泌代谢杂志，2013，29（2）：152-154.
［4］　STAGNARO-GREEN A，ABALOVIEH M，ALEXANDER E，et al.The American thyroid association taskforce on thyroid disease during pregnancy and postpartum guidelines of the American thyroid association for the diagnosis and management of thyroid disease during pregnancy and postpartum［J］.Thyroid，2011，21（10）：1-45.
［5］　李建新，王森，单忠艳，等.妊娠早期母体甲状腺功能及其抗体异常对妊娠结局的影响［J］.中华内分泌代谢杂志，2011，27（11）：916-919.
［6］　NELSON D B，CASEY B M，MCLNTIRE D D，et al.Subsequent pregnancy outcomes in women previously diagnosed with subclinical hypothyroidism［J］.Am J Perinatol，2014，31（1）：77-84.
［7］　TUDELA C M，CASEY B M，MCINTIRE D D，et al.Relationship of subclinical thyroid disease to the incidence of gestational diabetes［J］.Obstet Gynecol，2012，119（5）：983-988.
［8］　STAGNARO-GREEN A，PEARCE E.Thyroid disorders in pregnancy［J］.Nature Reviews Endocrinology，2012，8（11）：650-658.
［9］　ALLAN W C，HADDOW J E，PALOMAKI G E，et al.Maternal thyroid deficienoy and pregnancy complications：implications for population screening［J］.J Med Screen，2000，7（3）：127-130.
［10］　CASEY B M，DASHE J S，WELLS C E，et al.Subclinical hyperthyroidism and pregnancy outcomes［J］.Obstet Gyneeol，2006，107（2 pt l）：337-341.
［11］　李桂娟，林彩莲.妊娠母体甲状腺功能减退与母婴妊娠结局的相关性分析［J］.中国妇幼健康研究，2016，27（5）：643-646.
［12］　徐春慧.妊娠期甲状腺功能减低与妊娠结局的关系分析［J］.中国妇幼保健，2016，31（7）：1376 -1377.
［13］　TUDELA C M，CASEY B M，MCINTIRE D D，et al.Relationship of subclinical thyroid disease to the incidence of gestational diabetes［J］.Obstet Gynecol，2012，119（5）：983-988.
［14］　王睁，李利.妊娠期甲状腺功能减退症对子代影响的研究进展［J］.中华实用儿科临床杂志，2017，32（8）：631-633.
［15］　MARAKA S，SINGH OSPINA N M，O′KEEFFE D T，et al.Effects of increasing levothyroxine on pregnancy outcomes in women with uncontrolled hypothyroidism［J］.Clin Endocrinol，2017，86（1）：150-155.
［16］　CAPPELLI C，NEGRO R，PIROLA I，et al.Levothyroxine liquid solution versus tablet form for replacement treatment in pregnant women［J］.Gynecol Endocrinol，2016，32（4）：290-292.

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更新日期/Last Update: 2018-05-05