妊娠前半期妇女血清TSH水平与妊娠结局的相关性研究  

Relationship between TSH and pregnancy outcomes during the first half of pregnancy in women

作　　者：张菲[1] 彭伟[2] 林彦琳 王颜刚[1] 赵文娟[1] 

机构地区：[1]青岛大学附属医院内分泌科,266003 [2]青岛大学附属医院妇产科 [3]威海市中心医院内科

出　　处：《中华内分泌代谢杂志》2017年第1期52-55,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：随机选取妊娠前半期妇女352例，检测血清TSH、FT4，并随访妊娠结局。结合中国及美国甲状腺学会（ATA）2个指南的诊断标准中TSH水平不同进行分组：T1期对照组（0.1≤TSH≤2.5 mIU/L）、观察组（2.5〈TSH≤5.17mIU/L）、左旋甲状腺素（L-T4）治疗组（TSH〉5.17 mIU/L，L-T4治疗），T2期对照组（0.2≤TSH≤3.0 mIU/L）、观察组（3.0〈TSH≤5.22 mIU/L）、L-T4治疗组（TSH〉5.22 mIU/L）。结果显示，T1期观察组胎膜早破、早产及总妊娠不良结局发生率明显高于对照组（均P〈0.05），而治疗组与对照组各种妊娠不良结局差异均无统计学意义，T2期观察组胎膜早破发生率显著高于对照组（P〈0.05），余差异均无统计学意义。与T1期对照组比较，不良妊娠结局在观察组所占比率明显升高（P〈0.05）。妊娠前半期，尤其T1期TSH水平升高是妊娠不良结局的危险因素之一，早期有效的L-T4干预可使其明显减少。A total of 352 pregnant women were selected in Affiliated Hospital of Qingdao University. Serum levels of TSH and FT4 were determined and pregnancy outcome were observed in all subjects. According to the standard of American Thyroid Association（ATA）published in 2011 and the Chinese Guideline of Gestation Thyroid Disease published in 2012, the subjects were grouped into control（0.1≤TSH≤2.5 mIU/L）, observation（2.5〈TSH≤5.17 mIU/L）, levothyroxine（L-T4）treatment（TSH〉5.17 mIU/L）during first-trimester（T1）and control（0.2≤TSH≤3.0 mIU/L）, observation（3.0〈TSH≤5.22 mIU/L）, and L-T4 groups（TSH〉5.22 mIU/L）during second-trimester（T2）. The results showed that the rupture of membranes, preterm labor, and total obstetrical adverse events in the observation group were significantly higher than those in control group during T1（all P〈0.05）, no statistical significance between control group and treatment group. The rupture of membrances in the observation group was significantly higher compared with control group during T2（P〈0.05）, no significant difference in other adverse pregnancy outcomes between these two groups. Compared with control group during T1, the proportion of adverse pregnancy outcomes in observation group during T1 was significantly increased（P〈0.05）. The elevated TSH is one of the risk factors for the increased incidence of adverse pregnancy outcomes at the first half of pregnancy, especially during T1. L-T4 treatment reduces the incidence of adverse pregnancy outcomes.

关 键 词：妊娠前半期 促甲状腺素 妊娠结局 

分 类 号：R714[医药卫生—妇产科学]