妊娠期甲状腺功能减退症患者血糖血脂水平与病情严重程度及妊娠结局的关系  

Correlation between the blood glucose and lipid levels of pregnant women with hypothyroidism during pregnancy and their severity of hypothyroidism and pregnancy outcomes

作　　者：吴雪辉 李薇 吴欣瑜 陆欢 刘海凤 WU Xuehui;LI Wei;WU Xinyu;LU Huan;LIU Haifeng(The Second Affiliated Hospital of Chengdu Medical College(416 Hospital of Nuclear Industry),Chengdu,Sichuan Province,610057)

机构地区：[1]成都医学院第二附属医院·核工业四一六医院,成都610057

出　　处：《中国计划生育学杂志》2023年第1期182-186,共5页Chinese Journal of Family Planning

摘　　要：目的:探究妊娠期甲状腺功能减退症患者血糖血脂水平与病情严重程度及妊娠结局的关系。方法:收集2018年8月-2021年4月本院诊治的180例妊娠期甲状腺功能减退症(甲减)患者临床资料,根据甲减严重程度分为甲减组(n=75)、亚临床甲减组(n=59)、低甲状腺素血症组(n=46),根据妊娠结局将患者分为妊娠结局良好组(n=117)、不良妊娠结局组(n=63),比较各组糖代谢[空腹血糖(FBG)、糖化血红蛋白(HbAlc)]及脂代谢指标[甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)及低密度脂蛋白(LDL)]水平,分析个各指标对病情严重程度及妊娠结局的预测价值。结果:甲减组FBG水平高于亚临床甲减组、低甲状腺素血症组,甲减组、亚临床甲减组及低甲状腺素血症组患者HbAlc值及TG、LDL水平呈下降趋势(均P<0.05),3组TC、HDL水平无差异(P>0.05);结局良好组FBG、TG、LDL及HbAlc值均低于不良妊娠结局组(P<0.05),两组TC、HDL水平无差异(P>0.05)。FBG、HbAlc、TG、LDL水平与甲状腺功能减退症严重程度呈正相关(P<0.05)。糖脂代谢指标联合检测评估甲状腺功能减退症严重程度的曲线下面积(AUC=0.927)、预测妊娠结局(AUC=0.887)均大于各指标单独检测(均P<0.05)。结论:妊娠期甲状腺功能减退症患者存在糖脂代谢异常,糖脂代谢指标联合检测对患者甲减严重程度及妊娠结局均有评估价值。Objective:To explore the correlation between the blood glucose and lipid levels of pregnant women with hypothyroidism during pregnancy and their severity of hypothyroidism and pregnancy outcomes.Methods:The clinical data of 180 pregnant women with hypothyroidism during pregnancy between August 2018 and April 2021 were collected.According to the severity of hypothyroidism,these women were divided into group A1(75 women with hypothyroidism),group A2(59 women with subclinical hypothyroidism),and group A3(46 women with hypothyroxinemia).According to the pregnancy outcomes,these women were divided into group B1(117 women with normal pregnancy outcomes)and group B2(63 women with adverse pregnancy outcomes).The levels of glucose metabolism indexes,such as fasting blood glucose(FBG)and glycosylated hemoglobin(HbAlc),and lipid metabolism indexes,such as triglyceride(TG),total cholesterol(TC),high density lipoprotein(HDL),and low density lipoprotein(LDL),of the women were compared among the three groups,and the value of which for predicting for the severity of hypothyroidism and pregnancy outcomes was analyzed.Results:The FBG level of the women in group A1 was significantly higher than that of the women in group A2,and of the women in group A3.The levels of HbAlc,TG,and LDL of the women in group A1,group A2,and group A3 had decreased gradually(all P<0.05),there were no significant differences in the levels of TC and HDL of the women among the three groups(P>0.05).The levels of FBG,TG,LDL,and HbAlc of the women in group B1were significantly lower than those of the women in group B2(P<0.05),there were no significant differences in the TC and HDL levels of the women between the two groups(P>0.05).The levels of FBG,HbAlc,TG,and LDL of the women were positively correlated with their severity of hypothyroidism(P<0.05).The area under the curve(AUC)of the combined of glycemic and lipid metabolism indexes levels of the women for evaluating their severity of hypothyroidism and for predicting their pregnancy outcomes were 0.927and0.8

关 键 词：妊娠期 甲状腺功能减退症 糖脂代谢指标 病情程度 妊娠结局 评估价值 

分 类 号：R714.256[医药卫生—妇产科学]