超声对合并甲状腺功能亢进孕妇胎儿甲状腺功能的评估  

Ultrasonic assessment of fetal thyroid function through ultrasound in pregnant women with hyperthyroidism

作　　者：杨瑞琦[1] 祝贺[1] 张嘉玲[1] 王飞[1] 范丽梅[1] 

机构地区：[1]吉林大学第二医院妇产科,长春130041

出　　处：《中华医学杂志》2014年第35期2760-2762,共3页National Medical Journal of China

基　　金：吉林省科技厅重点科技攻关项目（20132068SF）

摘　　要：目的 探讨超声检查在产前评估合并甲状腺功能亢进孕妇胎儿甲状腺功能的价值,建立胎儿甲状腺横径、前后径随孕周变化的正常参考值范围.方法 2012年11月至2013年11月将吉林大学第二医院临床诊断为甲亢孕妇30例作为观察组,随机选取100例20～40孕周孕妇作为对照组,超声测量胎儿双顶径、头围、腹围、股骨长度、羊水指数、心率和胎儿甲状腺横径、前后径,并观察胎儿运动频率.观察组胎儿发育小于孕周、甲状腺测值高于对照组95％可信区间、心率＞160次/min或＜ 120次/min为可疑阳性病例,生后观察组胎儿行甲状腺素血清学测量.结果 对照组胎儿甲状腺横径和孕周线性回归方程为Y=0.053X-0.096,R2 =0.758,P＜0.05;对照组胎儿甲状腺前后径和孕周线性回归方程为Y=0.034X-0.397,R2 =0.596,P＜0.05;观察组胎儿甲状腺超声测值超过对照组95％可信区间2例,胎儿心率过快2例,心率过慢1例,生后血促甲状腺激素减低2例,甲状腺素升高1例,临床高值l例.结论 超声检查可以及时无创地评估胎儿甲状腺功能,对合并甲亢孕妇胎儿甲状腺功能的评估具有不可替代价值,并建立20～40孕周胎儿甲状腺超声测量正常参考值.Objective To explore the value of prenatal ultrasound in assessing thyroid function in fetuses of hyperthyroidism pregnant women and establish the reference values of fetal thyroid transverse diameter and anteroposterior diameter for different gestational weeks.Methods For observation group,30 cases of pregnant women diagnosed as hyperthyroidism were recruited from our hospital from November 2012 to November 2013.And another 100 cases of pregnant women during 20 to 40 weeks of gestational weeks were selected into control group.The measured ultrasonic parameters included fetal biparietal diameter,head circumference,abdominal circumference,femur length,amniotic fluid index,heart rate,fetal thyroid transverse diameter,anteroposterior diameter and fetal movement frequency.A fetus was considered as suspected positive when they were less than gestational age,thyroid measurement higher than 95% confidence interval,heart rate over 160 beats/min or less than 120 beats/min.In the observation group,the blood levels of thyroid stimulating hormone and thyroxine were measured after birth.Results The regression equation of fetal thymus transverse diameter and GA was：Y=0.053X-0.096,R2 =0.758,P 〈0.05; the regression equation of fetal thymus anteroposterior diameter and GA：Y =0.034X-0.397,R2 =0.596,P 〈 0.05.The measured value of 95% confidence interval for 2 cases in observation group exceeded that in control group.There were fetal tachycardia （n =2）,bradycardia （n =1）,low TSH after birth （n =2）,T4 elevation after birth （n =1） and clinical T4 high value （n =1）.Conclusion Ultrasonic assessment of fetal thyroid function is timely and noninvasive.And it has an irreplaceable value in hyperthyroidism pregnant women.And normal reference values of fetal thyroid measurements are established for 20-40 gestation weeks.

关 键 词：超声检查 胎儿 甲状腺 

分 类 号：R714.256[医药卫生—妇产科学]