妊娠期亚临床甲状腺功能减退症患者产后骨密度及骨代谢生化指标分析  

Analysis of changes in bone mineral density and biochemical indexes of bone metabolism in patients with subclinical hypothyroidism during pregnancy at 6 weeks postpartum

作　　者：陈秋景 冉爱冬[2] 黄春燕[1] CHEN Qiujing;RAN Aidong;HUANG Chunyan(Department of Endocrine, Guangxi Hechi People’s Hospital, Hechi 547000;Department of Obstetrics, Guangxi Hechi People’s Hospital, Hechi 547000,China)

机构地区：[1]河池市人民医院内分泌科,广西河池547000 [2]河池市人民医院产科,广西河池547000

出　　处：《中国骨质疏松杂志》2022年第5期685-688,共4页Chinese Journal of Osteoporosis

摘　　要：目的探讨妊娠期亚临床甲状腺功能减退症患者产后6周骨密度及骨代谢生化指标变化。方法选取2017年1月至2019年11月在我院妇产科建卡分娩的亚临床甲减孕妇68例为观察组,并选取同时期正常产检孕妇68例为对照组。所有入选孕妇均于妊娠中期和产后6周分别检测跟骨骨密度(采用超声骨密度仪检测,检测Z值)、维生素D、甲状旁腺素(parathyroid hormone,PTH)、骨钙素、Ⅰ型前胶原羧基末端肽(procollagen type I carboxy-terminal peptide,PICP)、血清钙、血清镁、血清磷。同时观察比较两组产妇产后6周健康状况。结果妊娠中期和产后6周观察组的血磷显著高于对照组(P<0.05),骨钙素、PICP水平和Z值均低于对照组(P<0.05);观察组妊娠中期与产后6周的骨钙素、PICP水平和Z值相比较差异均无统计学意义(P>0.05)。两组产妇产后6周健康状况比较差异无统计学意义(P>0.05)。结论妊娠期亚临床甲状腺功能减退症女性产后6周存在骨代谢异常,骨密度和骨钙素、PICP水平较低。在今后的临床实践中,建议规范产后随访制度,加强产后指导工作,对于产后骨代谢恢复有更大获益。Objective To explore the changes of bone mineral density and bone metabolism biochemical indexes in patients with subclinical hypothyroidism during pregnancy.Methods A total of 68 pregnant women with subclinical hypothyroidism who gave birth in the Department of Obstetrics and Gynecology in our hospital from January 2017 to November 2019 were selected as the observation group,and 68 pregnant women with normal obstetrics during the same period were selected as the control group.All selected pregnant women were tested for calcaneal bone mineral density(Using ultrasonic bone densitometer to detect,detecting the Z-value),vitamin D,parathyroid hormone(PTH),osteocalcin,type I procollagen carboxy-terminal peptide(PICP),serum calcium,serum magnesium,and serum phosphorus in the second trimester and 6 weeks postpartum.At the same time,observe and compare the health status of the two groups of mothers at 6 weeks postpartum.Results The blood phosphorus of the observation group during the second trimester and 6 weeks postpartum was significantly higher than that of the control group(P<0.05),and the average values of osteocalcin,PICP levels and Z-value were lower than those of the control group(P<0.05);the observation group during the second trimester and postpartum There were no statistically significant differences in the average values of osteocalcin,PICP levels and Z-value at 6 weeks(P>0.05).There was no significant difference in the health status of the two groups of parturients at 6 weeks postpartum(P>0.05).Conclusion Women with subclinical hypothyroidism during pregnancy have abnormal bone metabolism and low bone density,osteocalcin and PICP levels at 6 weeks postpartum.In future clinical practice,it is recommended to standardize the postpartum follow-up system and strengthen postpartum guidance,which will have greater benefits for postpartum bone metabolism recovery.

关 键 词：妊娠期 亚临床甲状腺功能减退 产后 骨密度 骨代谢 

分 类 号：R581.2[医药卫生—内分泌]