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妊娠期甲状腺功能减退患者并发子痫前期的风险分析(1)
http://www.100md.com 2017年10月8日 《中国医药科学》 2017年第15期
     [摘要] 目的 探讨妊娠期甲状腺功能减退患者并发子痫前期的危险因素。方法 回顾性分析2015年12月~ 2016年12月于我院行定期产检并分娩的妊娠期甲状腺功能减退孕妇780例,根据晚孕期甲状腺功能检测结果分为治愈组与未治愈组,对两组患者不同孕期甲状腺激素水平、子痫前期发生情况以及血压情况进行对比分析,统计两组孕妇的子痫前期发生率,使用多因素Logistic回归分析对子痫前期危险因素进行统计学分析。结果 孕早期,治愈组孕妇TSH水平低于未治愈组孕妇(P<0.05),而FT4水平差异无统计学意义(P>0.05),血压差异亦无统计学意义(P>0.05)。孕晚期,治愈组孕妇TSH水平显著低于未治愈组孕妇(P<0.01),收缩压亦显著低于未治愈组孕妇(P<0.01)。治愈组孕妇子痫前期发生率更低(P<0.05),进一步进行Logistic回归分析显示治愈组孕妇子痫前期发生风险显著降低。结论 妊娠期甲减孕妇的甲状腺功能恢复情况与子痫前期发生相关,该类患者改善甲状腺功能,可降低子痫前期的发生风险,对改善母婴预后有重要意义。

    [关键词] 妊娠期;甲状腺功能减退;子痫前期

    [中图分类号] R581.2 [文献标识码] A [文章编号] 2095-0616(2017)15-103-04

    [Abstract] Objective To investigate the risk factors of preeclampsia in patients with hypothyroidism during pregnancy. Methods 780 cases of hypothyroidism during pregnancy in our hospital from Dec.2015 to Dec.2016 were enroll in the study. According to the detection of thyroid function in the late pregnancy, the patients were divided into two groups: the cured group and the untreated group. The levels of thyroid hormone, preeclampsia and blood pressure in two groups of pregnant women were compared and analyzed. The incidence of preeclampsia in two groups of pregnant women was statistically analyzed, and the risk factors of preeclampsia were statistically analyzed by using multiple factor Logistic regression analysis. Results In the early pregnancy, the TSH level of the pregnant women in the treatment group was lower than that in the untreated group (P<0.05), but there was no significant difference in the level of FT4 (P>0.05), and there was no significant difference in the blood pressure (P>0.05). In the third trimester, the TSH level of the pregnant women in the treatment group was significantly lower than that in the untreated group (P<0.01), and the systolic blood pressure was also significantly lower than that in the untreated group (P<0.01). The incidence of preeclampsia was lower in the cured group (P<0.05). Further Logistic regression analysis showed that the risk of preeclampsia in the treated group was significantly lower. Conclusion Hypothyroidism in pregnant women is related to the occurrence of pre eclampsia. Improving thyroid function in these patients can reduce the risk of preeclampsia and is important for improving the prognosis of mother and newborn.

    [Key words] Pregnancy; Hypothyroidism; Pre eclampsia

    作為一类临床常见的内分泌系统疾病,妊娠期甲状腺功能减退症与流产、死胎、早产、妊娠期糖尿病、妊娠期高血压等诸多不良妊娠结局有关[1]。其中,子痫前期作为最为严重的并发症之一,会对母婴健康造成严重危害,是目前妊娠期甲减孕妇和围产儿死亡的首要原因[2]。关于妊娠期甲减合并子痫前期孕妇的临床治疗相关研究,已在国内外广泛展开,但却鲜有关于妊娠期甲减与子痫前期发病相关性分析及机制分析的报道。本研究回顾性分析2015年12月~2016年12月于我院行定期产检并分娩的妊娠期甲状腺功能减退孕妇780例,以探讨妊娠期甲状腺功能减退患者并发子痫前期的危险因素。结果令人满意,现报道如下。, 百拇医药(赵娅南 杨华 黎蕊)
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