妊娠合并低T4血癥對(duì)孕婦及新生兒的影響
發(fā)布時(shí)間：2018-08-02 14:42
【摘要】：目的通過檢測孕婦中晚孕期的血清促甲狀腺激素(TSH)、游離甲狀腺素(FT4)水平,探討孕婦低T4血癥的發(fā)生率及對(duì)孕婦及新生兒的不良影響,為及時(shí)發(fā)現(xiàn)和治療妊娠合并低T4血癥婦女提供依據(jù)。 研究對(duì)象回顧性分析了2013年1月至2013年10在廣西醫(yī)科大學(xué)一附院產(chǎn)科門診定期產(chǎn)檢并住院分娩的141例妊娠合并低T4血癥的孕婦及其新生兒的臨床資料作為研究組(其中治療組72例,未治療組69例),同期隨機(jī)選取58例在我院定期產(chǎn)檢并分娩的無甲狀腺功能異常并且無其他合并癥的孕婦作為對(duì)照組。 研究方法通過測定治療組、未治療組及正常組孕婦中、晚孕期的游離甲狀腺素(FT4)、促甲狀腺激素(TSH)水平；進(jìn)一步了解孕婦妊娠中期、晚期甲狀腺功能水平的變化(或差異);統(tǒng)計(jì)各組孕婦發(fā)生并發(fā)癥及妊娠不良結(jié)局的發(fā)生率；比較各組新生兒出生一般情況及出生72小時(shí)后的血清游離甲狀腺素(FT4)與促甲狀腺激素(TSH)水平。 結(jié)果①妊娠期血清TSH、FT4的變化：中孕期：治療組與未治療組TSH的均值均高于正常組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。晚孕期：未治療組TSH顯著高于治療組與正常組的TSH,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；而治療組與正常對(duì)照組相比差異無統(tǒng)計(jì)學(xué)意義(P0.05)。中、晚孕期：治療組、未治療組的FT4的均值低于正常組的FT4,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；而妊娠晚期治療組與未治療組的FT4相比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。②未治療組的孕婦在晚孕期發(fā)展為甲減的發(fā)生率顯著高于治療組及正常組的孕婦,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。未治療組的孕婦妊娠期糖尿病的患病率顯著高于治療組及正常組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療組及未治療組孕婦的妊娠期高血壓疾病患病率明顯高于正常組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。③治療組及未治療組的孕婦分娩的新生兒體重2500g比例明顯高于正常組比例,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。而比較治療組、未治療組及正常組孕婦分娩的新生兒的體重、一分鐘Apgar評(píng)分秩均值及早產(chǎn)率,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。④未治療組孕婦的新生兒甲減患病率顯著高于治療組及正常組孕婦的新生兒甲減患病率,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療組與未治療組孕婦的新生兒的血清TSH水平顯著高于正常組孕婦新生兒的TSH水平,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；但治療組與未治療組孕婦的新生兒血清TSH水平差異無統(tǒng)計(jì)學(xué)意義(P0.05)。比較治療組、未治療組及正常組孕婦的新生兒的血清FT4水平,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論①妊娠合并低T4血癥的孕婦經(jīng)過治療后TSH水平明顯降低,與正常孕婦晚孕期TSH水平無差異,表明治療是有效的。②妊娠合并低T4血癥與妊娠期糖尿病、新生兒低出生體重等妊娠不良結(jié)局相關(guān),孕期檢測并調(diào)整FT4水平有重要意義或孕期檢測甲功并及時(shí)治療低T4血癥有重要意義。③未治療的低T4血癥孕婦的新生兒甲減患病率明顯高于治療組及正常組孕婦的新生兒甲減患病率。④妊娠合并低T4血癥孕婦的新生兒的血清TSH水平明顯高于正常組孕婦的新生兒的血清TSH水平。⑤孕婦妊娠期低T4血癥的發(fā)病率較高,且進(jìn)展為臨床甲減及亞臨床甲減的幾率高,孕期開展甲狀腺功能篩查并監(jiān)測甲狀腺功能及時(shí)發(fā)現(xiàn)、治療甲狀腺疾病,對(duì)減少孕婦妊娠期合并癥、并發(fā)癥及孕婦和新生兒的不良結(jié)局的發(fā)生有重要意義。
[Abstract]:Objective to investigate the incidence of hypothyroidemia in pregnant women and the adverse effects on pregnant women and newborns by detecting the level of serum thyrotropin (TSH) and free thyroxine (FT4) during the middle and late pregnancy of pregnant women, and to provide the basis for the timely discovery and treatment of women with hypothyroidemia in pregnancy.
The objective of the study was to review the clinical data of 141 pregnant women and their neonates in the obstetrics outpatient department of Guangxi Medical University from January 2013 to 2013 as the study group (72 cases in the treatment group and 69 cases in the untreated group). 58 cases were randomly selected and divided in our hospital during the same period. 10 cases were randomly selected and divided in our hospital. The pregnant women without thyroid dysfunction and without other complications were used as control group.
The study method was used to determine the level of free thyroxine (FT4) and thyroid stimulating hormone (TSH) in the late pregnancy, in the treatment group, the untreated group and the normal group, and to further understand the changes in the middle trimester of pregnancy and the advanced thyroid function (or difference); the incidence of complications and adverse outcomes of pregnant women in each group were compared. The general situation of newborn birth and serum free thyroxine (FT4) and thyroid stimulating hormone (TSH) level 72 hours after birth.
Results (1) the changes in serum TSH and FT4 during pregnancy: mid pregnancy: the mean value of TSH in the treatment group and the untreated group was higher than that in the normal group, the difference was statistically significant (P0.05). The TSH in the untreated group was significantly higher than the TSH in the treatment group and the normal group (P0.05), but there was no statistical difference between the treatment group and the normal control group. Significance (P0.05), middle and late pregnancy: the mean value of FT4 in the treatment group was lower than that of the normal group FT4, the difference was statistically significant (P0.05), but the difference was statistically significant (P0.05) compared with those in the untreated group (P0.05). (2) the incidence of hypothyroidism in pregnant women in the untreated group was significantly higher than that of the treatment group. The difference between the pregnant women in the normal group was statistically significant (P0.05). The prevalence rate of gestational diabetes in the untreated group was significantly higher than that in the treatment group and the normal group. The difference was statistically significant (P0.05). The prevalence rate of pregnancy induced hypertension in the treatment group and the untreated group was significantly higher than that in the normal group (P0.05). The proportion of birth weight 2500g of pregnant women in the group and untreated group was significantly higher than that of the normal group, and the difference was statistically significant (P0.05). But in the comparison group, the weight of the newborn babies born in the untreated group and the normal group were not statistically significant (P0.05). (P0.05). (4) the pregnant women in the untreated group had no statistical significance (P0.05). The incidence of hypothyroidism in newborn infants was significantly higher than that in the treatment group and the normal group. The difference was statistically significant (P0.05). The serum TSH level of the newborns in the treatment group and the untreated group was significantly higher than that of the normal group, and the difference was statistically significant (P0.05), but the treatment group and the untreated group were pregnant women. There was no significant difference in the level of serum TSH in newborn infants (P0.05). Compared with the treatment group, there was no significant difference in serum FT4 level between the untreated group and the normal group (P0.05).
Conclusions (1) the level of TSH in pregnant women with hypoxemia after pregnancy is significantly reduced, and there is no difference between the level of TSH and the level of TSH in the late pregnancy of the normal pregnant women. It indicates that the treatment is effective. (2) the combination of pregnancy with low T4 and gestational diabetes and low birth weight of the newborn is related to the adverse outcome of pregnancy, and the pregnancy detection and adjustment of the level of FT4 are of great significance or pregnancy. The detection of thyroid function and timely treatment of hypothyroidemia is of great significance. (3) the incidence of hypothyroidism in neonates with low T4 in untreated pregnant women is significantly higher than that in the treatment group and the normal group of pregnant women. (4) the serum TSH level of the newborn infants with pregnancy combined with low T4 is higher than that of the serum TSH water of the normal pregnant women. The incidence of hypothyroidism in pregnant women's pregnancy is high, and the incidence of hypothyroidism and subclinical hypothyroidism is high. It is important to carry out thyroid function screening and monitor thyroid function timely, to treat thyroid disease, to reduce pregnancy complications, complications and adverse outcomes of pregnant women and neonates during pregnancy. Righteousness.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R714.254
本文編號(hào)：2159765
[Abstract]:Objective to investigate the incidence of hypothyroidemia in pregnant women and the adverse effects on pregnant women and newborns by detecting the level of serum thyrotropin (TSH) and free thyroxine (FT4) during the middle and late pregnancy of pregnant women, and to provide the basis for the timely discovery and treatment of women with hypothyroidemia in pregnancy.
The objective of the study was to review the clinical data of 141 pregnant women and their neonates in the obstetrics outpatient department of Guangxi Medical University from January 2013 to 2013 as the study group (72 cases in the treatment group and 69 cases in the untreated group). 58 cases were randomly selected and divided in our hospital during the same period. 10 cases were randomly selected and divided in our hospital. The pregnant women without thyroid dysfunction and without other complications were used as control group.
The study method was used to determine the level of free thyroxine (FT4) and thyroid stimulating hormone (TSH) in the late pregnancy, in the treatment group, the untreated group and the normal group, and to further understand the changes in the middle trimester of pregnancy and the advanced thyroid function (or difference); the incidence of complications and adverse outcomes of pregnant women in each group were compared. The general situation of newborn birth and serum free thyroxine (FT4) and thyroid stimulating hormone (TSH) level 72 hours after birth.
Results (1) the changes in serum TSH and FT4 during pregnancy: mid pregnancy: the mean value of TSH in the treatment group and the untreated group was higher than that in the normal group, the difference was statistically significant (P0.05). The TSH in the untreated group was significantly higher than the TSH in the treatment group and the normal group (P0.05), but there was no statistical difference between the treatment group and the normal control group. Significance (P0.05), middle and late pregnancy: the mean value of FT4 in the treatment group was lower than that of the normal group FT4, the difference was statistically significant (P0.05), but the difference was statistically significant (P0.05) compared with those in the untreated group (P0.05). (2) the incidence of hypothyroidism in pregnant women in the untreated group was significantly higher than that of the treatment group. The difference between the pregnant women in the normal group was statistically significant (P0.05). The prevalence rate of gestational diabetes in the untreated group was significantly higher than that in the treatment group and the normal group. The difference was statistically significant (P0.05). The prevalence rate of pregnancy induced hypertension in the treatment group and the untreated group was significantly higher than that in the normal group (P0.05). The proportion of birth weight 2500g of pregnant women in the group and untreated group was significantly higher than that of the normal group, and the difference was statistically significant (P0.05). But in the comparison group, the weight of the newborn babies born in the untreated group and the normal group were not statistically significant (P0.05). (P0.05). (4) the pregnant women in the untreated group had no statistical significance (P0.05). The incidence of hypothyroidism in newborn infants was significantly higher than that in the treatment group and the normal group. The difference was statistically significant (P0.05). The serum TSH level of the newborns in the treatment group and the untreated group was significantly higher than that of the normal group, and the difference was statistically significant (P0.05), but the treatment group and the untreated group were pregnant women. There was no significant difference in the level of serum TSH in newborn infants (P0.05). Compared with the treatment group, there was no significant difference in serum FT4 level between the untreated group and the normal group (P0.05).
Conclusions (1) the level of TSH in pregnant women with hypoxemia after pregnancy is significantly reduced, and there is no difference between the level of TSH and the level of TSH in the late pregnancy of the normal pregnant women. It indicates that the treatment is effective. (2) the combination of pregnancy with low T4 and gestational diabetes and low birth weight of the newborn is related to the adverse outcome of pregnancy, and the pregnancy detection and adjustment of the level of FT4 are of great significance or pregnancy. The detection of thyroid function and timely treatment of hypothyroidemia is of great significance. (3) the incidence of hypothyroidism in neonates with low T4 in untreated pregnant women is significantly higher than that in the treatment group and the normal group of pregnant women. (4) the serum TSH level of the newborn infants with pregnancy combined with low T4 is higher than that of the serum TSH water of the normal pregnant women. The incidence of hypothyroidism in pregnant women's pregnancy is high, and the incidence of hypothyroidism and subclinical hypothyroidism is high. It is important to carry out thyroid function screening and monitor thyroid function timely, to treat thyroid disease, to reduce pregnancy complications, complications and adverse outcomes of pregnant women and neonates during pregnancy. Righteousness.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R714.254
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相關(guān)期刊論文 前3條
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，本文編號(hào)：2159765
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