妊娠前半期甲状腺功能异常与妊娠期糖尿病的临床研究  

Study of thyroid dysfunction in the first half of pregnancy and gestational diabetes mellitus

作　　者：李利平[1] 姜宏卫[2] 付留俊[2] 袁园[2] 宋白利[2] 秦贵军[1] 

机构地区：[1]河南郑州大学第一附属医院内分泌科,450052 [2]河南洛阳河南科技大学第一附属医院内分泌科,471000

出　　处：《实用医学杂志》2016年第19期3127-3129,共3页The Journal of Practical Medicine

基　　金：洛阳市青年医学科技创新联合资金项目(编号:150411)

摘　　要：目的：探讨妊娠前半期（≤20周）甲状腺功能异常对妊娠期糖尿病（GDM）的影响。方法：采用前瞻性干预研究的方法，收集我院围产保健门诊建档的孕妇，测定甲状腺功能，依美国甲状腺协会（ATA）标准判定甲功，分为甲功正常组和甲功异常组，甲功异常组给予相应的干预治疗。追踪观察全部入组孕妇，24-28周行75 g OGTT，依国际糖尿病研究组（IADPSG）标准诊断GDM。χ2分析比较不同甲状腺功能组GDM的患病情况。结果：共收集孕妇1062例，甲功正常组857例，亚临床甲亢14例（1．32％），亚临床甲减164例（15．4％），低T4血症22例（2．07％），临床甲减5例（0．47％）。低T4血症组与甲功正常组相比 GDM 患病明显增高（54．5％ vs 27．8％，P ＝0．006），余与正常甲功组相比GDM患病率无统计学差异。结论：妊娠前半期甲功异常与GDM发病相关，应重视妊娠期甲功异常的筛查和治疗。Objective To explore the influence of thyroid dysfunction in the first half pregnancy （≤20 gestational weeks） on gestational diabetes. Methords By adopting the method of prospective intervention study, general data of pregnant-women in the care clinics of our hospital were collected. Thyroid function was detected and evaluated by ATA criteria. All cases were divided into two groups： normal thyroid function group and thyroid dysfunction group. The thyroid dysfunction group was intervened. 75 g OGTT were conducted in all cases in 24-28 gestational-weeks. GDM was diagnosed by IADPSG diagnostic criteria. GDM prevalence was compared between normal thyroid function group and abnormal thyroid function groups. Results 1 062 cases of pregnant women were collected. 857 cases of pregnant women were normal, while 14 cases were subclinical hyperthyroidism （1.32%）, 164 cases were subclinical hypothyroidism （15.4%）, 22 cases were hypothyroxinemia （2.07%）. Compared with normal thyroid function, prevalence rate of GDM was the highest in hypothyroxinemia group （54.5% vs 27.8%）. There was no significant difference between subclinical hypothyroidism group and normal thyroid function group. Conclusion Thyroid dysfunction in the first half pregnancy is associated with GDM , Screening and treatment of pregnant thyroid dysfunction should be attached.

关 键 词：甲功异常 妊娠糖尿病 

分 类 号：R714.256[医药卫生—妇产科学]