妊娠≤20周孕妇外周血促甲状腺素、游离甲状腺素及游离三碘甲状腺原氨酸水平对母婴分娩结局的影响

摘要
图/表
参考文献(15)
相关文章 (15)

全文: PDF (0 KB) HTML (36 KB)
输出: BibTeX | EndNote (RIS)

摘要目的对妊娠早期孕妇血清促甲状腺素（TSH）、游离甲状腺素（FT4）及游离三碘甲状腺原氨酸（FT3）水平与母婴分娩结局进行比较，考察其对母婴分娩结局的影响。方法选取2015年2月～2017年2月我院妇产科收治孕妇，按照甲状腺功能筛查结果分为甲状腺异常组80例（临床甲减组24例和亚临床甲减组56例）、治疗组66例（临床甲减组22例和亚临床甲减组44例）和同期甲状腺功能正常104例为对照组，对250例研究对象行TSH、FT3、FT4水平检测，治疗组妊娠12周时应用左旋甲状腺素（L-T4）进行治疗，密切监测TSH、FT3和FT4水平直至分娩，对比各组不同时段TSH、FT3和FT4水平及新生儿和母体不良结局。结果与对照组比较，临床甲减组和亚临床甲减组TSH、FT3和FT4水平差异均有统计学意义（P＜0.05）；经对症治疗后，临床甲减和亚临床甲减治疗组新生儿不良结局发生率均低于临床甲减组和亚临床甲减异常组，亚临床甲减治疗组母体并发症发生率低于亚临床甲减异常组，差异有统计学意义（P＜0.05）。结论妊娠早期产检时行TSH、FT3、FT4联合检测可准确及时发现甲状腺功能异常，经早期治疗改善妊娠不良结局，可有效提高分娩的安全性。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	常莉萍

关键词 ：妊娠早期, 甲状腺激素, 促甲状腺激素, 游离甲状腺素, 妊娠结局

Abstract：Objective To investigate the relationship between early pregnancy maternal serum thyrotropin(TSH),free triiodothyronine(FT3),free thyroxine(FT4)levels and maternal birth outcomes,in order to study the effect of maternal birth outcomes.Methods From February 2015 to February 2017,250 cases in our hospital obstetrics were collected according to screening results of the thyroid function and divided into 80 cases in thyroid abnormalities groups(24 cases of clinical hypothyroidism and 56 cases of subclinical hypothyroidism),66 cases in the treatment groups(22 cases of clinical hypothyroidism and 44 cases of subclinical hypothyroidism)and 104 cases of normal thyroid function as the control group.TSH,FT3,FT4level were detected among all subjects.At the 12 weeks of pregnancy,treatment group underwent levothyroxine(L-T4)treatment,and TSH,FT3and FT4levels were close monitoring until delivery,when the levels of TSH,FT3and FT4in each group in different times as well as neonatal and maternal outcomes were compared.Results Compared with the control group,the differences of TSH,FT3and FT4levels in the clinical hypothyroidism group and subclinical hypothyroidism groups were statistically significant(P＜0.05),adverse neonatal outcomes rate in hypothyroidism and subclinical hypothyroidism treatment groups were significantly lower than abnormalities groups after symptomatic treatment,treatment of subclinical hypothyroidism group had lower incidence rate of maternal complications than abnormalities subclinical hypothyroidism group,the differences were statistically significant(P＜0.05).Conclusion Early pregnancy joint detection in TSH,FT3,FT4level can figure out the abnormal thyroid function timely and accurately,which can effectively improve the security of delivery under the timely diagnosis and early treatment.

Key words： Early pregnancy Thyroid hormone Thyroid stimulating hormone Free thyroxine Pregnancy outcome

作者简介: 常莉萍（1976-），女，汉族，本科，副主任医师，研究方向：妇产疾病

引用本文:

常莉萍. 妊娠≤20周孕妇外周血促甲状腺素、游离甲状腺素及游离三碘甲状腺原氨酸水平对母婴分娩结局的影响[J]. 中国当代医药, 2018, 25(1): 88-91.
CHANG Li-ping. Effect of peripheral blood TSH，FT4and FT3levels on maternal and child birth outcomes in pregnant women less than 20 weeks of pregnancy. 中国当代医药, 2018, 25(1): 88-91.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2018/V25/I1/88

[1]	张菲，彭伟，林彦琳，等.妊娠前半期妇女血清TSH水平与妊娠结局的相关性研究[J].中华内分泌代谢杂志，2017，33（1）：52-55.
[2]	Jacob H，Peters C.Screening，diagnosis and management of congenital hypothyroidism：European Society for Paediatric Endocrinology Consensus Guideline[J].Arch Dis Child Educ Pract Ed，2015，100（5）：260-263.
[3]	朱丽，邹秀兰.孕期 TSH、TPO-AB、FT4及 FT3检测对母胎并发症的影响 [J]. 中国妇幼保健，2015，30 （12）：1835-1836.
[4]	薄春敏，张静，何莉梅，等.FT4、TSH、TPOAb 联合检测在妊娠早期妇女中的应用价值[J].国际检验医学杂志，2016，37（8）：1105-1107.
[5]	Horvat O，Tomic Z，Mijatovic V，et al.Drug utilization in treatment of thyroid disorders during pregnancy in serbia[J].Med Pregl，2016，69（1-2）：11-15.
[6]	沈菲.妊娠早期甲状腺功能检查与妊娠结局[J].当代医学，2015，21（36）:66-67.
[7]	Alexander EK，Pearce EN，Brent GA，et al.2017 guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum[J].Thyroid，2017，27（3）：315-389.
[8]	肖锋，黄敏华，苏丽媚.甲状腺功能检查在孕前检查中的意义[J].现代医院，2013,13（4）：68.
[9]	Hubalewska-Dyd ejczyk A，Trofimiuk-Müldner M.The development of guidelines for management of thyroid diseases in pregnancy-current status[J].Thyroid Res，2015，8（S1）：1-3.
[10]	谢秋娴，杨纯，谢昭雄，等.妊娠合并甲状腺功能减退症经激素替代治疗的妊娠结局分析[J].河北医学，2016，22（1）：89-92.
[11]	Pearce EN.Thyroid disorders during pregnancy and postpartum.[J].Best Pract Res Clin Obstet Gynaecol，2015，29（5）：700-706.
[12]	陈娟文，周颖娴，陈丹霞.激素替代疗法对妊娠合并甲状腺功能减退症患者妊娠结局的影响[J].临床医学，2017，37（4）：41-43.
[13]	Giacobbe AM，Grasso R，Triolo O，et al.Thyroid diseases in pregnancy：a current and controversial topic on diagnosis and treatment over the past 20 years[J].Arch Gynecol Obstet，2015，292（5）：995-1002.
[14]	马科航，杨亮.甲状腺疾病患者血清三碘甲腺原氨酸、甲状腺素和促甲状腺素的检测分析[J].现代诊断与治疗，2014，25（8）:1872-1873.
[15]	Robinson H，Robinson P，D'Emden M，et al.Management of thyroid disease in pregnancy-room for improvement in the first trimester[J].Obstet Med，2016，9（3）：126-129.