妊娠期糖尿病和妊娠期高血压孕妇甲状腺功能的动态观察  

Dynamic observation of thyroid function in pregnant women with gestational diabetes mellitus and gestational hypertension

作　　者：田波[1] 吴艳[1] 朱晓荣[1] 秦娟[1] 黄秀丽[1] 蒋莉[1] 喻荷淋[1] 付彩雯[1] 陈诚[1] 刘阳[1] TIAN Bo;WU Yan;ZHU Xiao-rong;QIN Juan;HUANG Xiu-li;JIANG Li;YU He-lin;FU Cai-wen;CHEN Cheng;LIU Yang(Department of Endocrinology,Suining Central Hospital,Suining 629000,China)

机构地区：[1]四川省遂宁市中心医院内分泌科,四川遂宁629000

出　　处：《实用医院临床杂志》2020年第3期120-122,共3页Practical Journal of Clinical Medicine

基　　金：四川省卫生和计划生育委员会科研资金资助项目(编号:16PJ521).

摘　　要：目的探讨妊娠期糖尿病和妊娠期高血压与甲状腺功能的联系。方法2016年5月至2018年5月于我院就诊的孕妇828例,根据其是否合并有妊娠期糖尿病或妊娠期高血压分为健康对照组539例、妊娠期高血压组82例以及妊娠期糖尿病组207例。在孕早期、孕中期以及孕晚期检测甲状腺功能,比较三组不同妊娠时期游离甲状腺素(FT4)水平、促甲状腺激素(TSH)水平和妊娠期甲状腺疾病发生率。结果在孕中期,妊娠期糖尿病组孕妇FT4水平显著低于妊娠期高血压组和对照组;在孕中期以及孕晚期,妊娠期糖尿病组及妊娠期高血压组孕妇TSH水平显著高于对照组,两组孕妇低T4血症的发生率显著高于对照组;妊娠期糖尿病组亚临床功能减退的发生率明显高于妊娠期高血压组和对照组,差异有统计学意义(P<0.05);三组间血抗甲状腺过氧化物酶抗体(TPOAb)抗体阳性和亚临床甲状腺功能亢进症的发生率差异无统计学意义(P>0.05)。结论孕妇妊娠期糖尿病、妊娠期高血压与甲状腺功能异常的发生关系密切,特别是在孕中期以及孕晚期,应当加强对甲状腺功能的相关指标尤其是TSH以及FT4的监测。Objective To explore the relationship between thyroid function and gestational diabetes mellitus and gestational hypertension.Methods A retrospective analysis was made on 828 pregnant women who visited our hospital from May 2016 to May2018.They were divided into control group(N=539),pregnancy hypertension group(N=82)and gestational diabetes mellitus group(N=207)according to whether they had gestational diabetes mellitus or gestational hypertension.Thyroid function was assessed in the first,second and third trimester of pregnancy.The levels of FT4 and TSH in different trimesters of pregnancy and the incidence of thyroid disease during pregnancy were compared among the three groups.Results In the second trimester of pregnancy,FT4 level of pregnant women in the gestational diabetes mellitus group was significantly lower than that in the pregnancy hypertension group and the control group.In the second trimester and the third trimester of pregnancy,TSH level of pregnant women in the gestational diabetes mellitus group and the gestational hypertension group was significantly higher than that in the control group.The incidence of hypothyroxinemia in the two groups was significantly higher than that in the control group.The incidence of subclinical hypothyroidism in the gestational diabetes group was significantly higher than that in the gestational hypertension group and the control group.There was no statistical difference in the incidence of hyperthyroidism and TPOAb positive.Conclusion Gestational diabetes mellitus and gestational hypertension are closely related to thyroid function,especially in the second trimester and the third trimester of pregnancy.It is necessary to strengthen the monitoring of thyroid related indicators.

关 键 词：甲状腺功能 妊娠期糖尿病 妊娠期高血压 相关性 

分 类 号：R581.9[医药卫生—内分泌]