妊娠中期妇女亚临床甲状腺异常对后代智力发育影响的研究  

Effect of maternal subclinical thyroid abnormalities on offspring＇s intellectual development

作　　者：李元宾[1] 滕卫平[1] 单忠艳[1] 张丽[3] 赵亚茹[2] 于晓会[1] 李玉姝[1] 王薇薇[1] 赵云静[2] 华天懿[2] 杨柳[3] 范晨玲[1] 王红[1] 郭锐[1] 

机构地区：[1]中国医科大学附属第一医院内分泌科,内分泌研究所,沈阳110001 [2]中国医科大学附属盛京医院发育儿科 [3]沈阳市妇幼保健所

出　　处：《中华内分泌代谢杂志》2008年第6期601-604,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：基金项目：“十五”国家科技攻关计划项目（2004BA720A）;卫生行业科研专项项目（200802008）;辽宁省重点实验室专项资金计划项目（辽科发[2005]36号-39）;辽宁省科学技术计划项目（2007225010）

摘　　要：目的研究妊娠16—20周妇女亚临床甲状腺异常[包括亚临床甲状腺功能减退症（甲减），低Td血症和甲状腺功能正常但甲状腺过氧化酶抗体（TPOAb）阳性]对后代智力发育和运动能力的影响。方法选择1268名妊娠16～20周妇女2年前保存的血清，测定其TSH、TT4、FT4和TPOAb。应用妊娠特异的甲状腺功能参考值，筛查获得亚临床甲减18例，低T4血症者19例，甲状腺功能正常但TPOAb阳性者34例。按1：2比例选择同批142名甲状腺功能正常且TPOAb阴性同孕龄妇女做对照，对她们的后代在25—30月龄时进行智力和运动发育指数测评。结果妊娠16—20周母亲亚临床甲减组后代智力评分为（109．89±13．81）分，比对照组低8．88分（P〈0．01）；运动评分（108．11±9．93）分，比对照组低9．98分（P〈0．01）。低T。血症组后代的智力评分为（112．32±15．10）分，比对照组低9．30分（P〈0．01）；运动评分（112．21±12．26）分，比对照组低7．57分（P〈0．01）。甲状腺功能正常TPOAb阳性组后代的智力评分为（112．70±20．64）分，比对照组低10．56分（P〈0．01）；运动评分（110．64±12．49）分，比对照组低9．03分（P〈0．01）。结论妊娠16～20周妇女亚临床甲状腺功能异常皆有可能给后代智力和运动发育造成不良影响，提示筛查和治疗妊娠前半期亚临床甲状腺异常有其必要性。Objective To study the effect of maternal subclinical thyroid abnormalities [ including subclinical hypothyroidism, hypothyroxinemia and positive anti-thyroid peroxidase antibody （TPOAb） with normal thyroid function] in women during 16-20 weeks of gestation on offspring＇s intellectual development and motor function. Methods Sera from 1 268 women during 15-20 weeks of gestation （collected 2 yearn ago ） were obtained and thyroid stimulating hormone （TSH）, total thyroxine （FT4 ）, free thyroxine （FT4 ） and TPOAb levels were measured. Pregnant specific thyroid function reference ranges were used to screen for subclinical hypothyroidism （ 18 cases） , hypothyroxinemia （ 19 cases） and positive TPOAb （34 cases）. From the same cohort, a total of 142 pregnant women who were euthyroid with negative TPOAb were selected as controls （ a case ： control ratio of 1 ： 2 ）. Intellectual and motor development score evaluations were performed in their children at 25-30 months of age. Results In the group of pregnant women with subclinical hypothyroidism, the offspring＇ s intelligence score was （ 109.89 ± 13.81 ） points, which was 8.88 points lower than in the control group （P 〈 0.01 ）. Similarly, the motor score of the offspring was （ 108.11 ± 9.93 ） points, which was 9.98 points lower than in the control group （P 〈0.01 ）. In the pregnant women with hypothyroxinemia, the offspring＇s intelligence score was （ 112.32 ± 15.10） points, 9.30 points lower than in the control group （P 〈0.01 ） ; the motor score was （112.21 ± 12.26）points, 7.57 points lower than in the control group （P 〈 0.01 ）. In the pregnant women with positive TPOAb and euthyroid function, the offspring＇s intelligence score was （112.70 ± 20.64 ）points, 10.56 points lower than in the control group （ P 〈 0.01 ） ; the motor score was （ 110.54 ± 12.49 ） points, 9.03 points lower than in the control group （P 〈 0.01 ）. Conclusion Maternal subclinical thyroid abnormali

关 键 词：妊娠 亚临床甲状腺异常 甲状腺过氧化物酶抗体 后代 智力发育 

分 类 号：R714.256[医药卫生—妇产科学]