| 路春梅,齐俊巧,杨 旭,范春燕,赵云刚.妊娠期妇女甲状腺功能的筛查情况及相关影响因素分析[J].,2020,(20):3983-3987 |
| 妊娠期妇女甲状腺功能的筛查情况及相关影响因素分析 |
| Analysis of Thyroid Function Screening in Pregnant Women and Related Influencing Factors |
| 投稿时间：2020-04-23 修订日期：2020-05-18 |
| DOI：10.13241/j.cnki.pmb.2020.20.040 |
| 中文关键词: 妊娠妇女 甲状腺功能筛查 影响因素 |
| 英文关键词: Pregnant Women Thyroid function screening Influence factor |
| 基金项目:河北省卫计委2019年度医学科学研究重点项目（20191388）；秦皇岛市科技支撑计划项目（201602A169） |
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| 中文摘要: |
| 摘要 目的：了解妊娠期妇女甲状腺功能的筛查情况及相关影响因素。方法：以2016年1月~2017年1月在我院接受产前检查的400例孕妇为研究对象，其中早期妊娠78例、中期妊娠146例、晚期妊娠176例，同期健康体检合格妇女120例为对照组。比较妊娠妇女和对照组促甲状腺激素（TSH）、游离T3（FT3）及游离T4（FT4）水平，并分析妊娠合并甲状腺功能异常者妊娠不良结局发生情况，并分析妊娠合并甲状腺功能异常的影响因素。结果：400例孕妇中，亚临床甲减62例、临床甲减5例、亚临床甲亢16例、临床甲亢2例，甲状腺疾病合计85例。孕早期TSH低于孕中期及孕晚期，FT3浓度高于孕中期及孕晚期，FT4浓度高于孕中期及孕晚期，孕中期及孕晚期TSH水平高于对照组，孕中期及孕晚期FT3、FT4浓度低于对照组，差异有统计学意义（P<0.05）。不同年龄、流产次数、碘摄入量、吸烟组妊娠合并甲状腺功能异常率差异比较有统计学意义（P<0.05）。Logistic回归分析，年龄≥30岁、流产次数≥2次、碘摄入量≥150 μg/d为妊娠合并甲状腺功能异常发生的独立危险因素。妊娠合并甲状腺功能异常组妊娠不良结局合计率高于妊娠合并甲状腺功能正常组（P<0.05）。结论：加强对妊娠期妇女甲状腺功能的筛查和高危因素的管理能够预防不良妊娠结局，达到优生优育。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the screening situation of thyroid function in pregnant women and related influencing factors. Methods: 400 pregnant women who underwent prenatal examination in our hospital's maternity clinic from January 2016 to January 2017 were selected as the research objects, including 78 cases of early pregnancy, 146 cases of mid-term pregnancy and 176 cases of late pregnancy, and 120 pregnant women who underwent health examination in our hospital's outpatient clinic during the same period were selected as the control group. The incidence of thyroid dysfunction in pregnant women was analyzed. The levels of thyroid stimulating hormone (TSH), free T3(FT3) and free T4(FT4) were compared between pregnant women and control group. The incidence of adverse pregnancy outcomes in pregnant women with thyroid dysfunction was analyzed, the incidence of adverse pregnancy outcomes in pregnant women with thyroid dysfunction was analyzed. Results: Of 400 pregnant women, 62 had subclinical hypothyroidism, 5 had clinical hypothyroidism, 16 had subclinical hyperthyroidism, 2 had clinical hyperthyroidism, and 85 had thyroid diseases. TSH in the first trimester of pregnancy was lower than that in the second trimester and the third trimester of pregnancy, FT3 concentration was higher than that in the second trimester and the third trimester of pregnancy, FT4 concentration was higher than that in the second trimester and the third trimester of pregnancy, TSH level in the second trimester and the third trimester of pregnancy was higher than that in the control group, FT3 and FT4 concentration in the second trimester and the third trimester of pregnancy was lower than that in the control group, there was a statistical difference (P<0.05). There were statistically significant differences among different ages, abortion times, iodine intake and pregnancy complicated with thyroid dysfunction rate in smoking group (P<0.05). Logistic regression analysis showed that Age ≥30 years old, number of abortions ≥2, iodine intake ≥150 μg/d were independent risk factors for thyroid dysfunction in pregnancy. The total rate of adverse pregnancy outcomes in pregnancy combined with thyroid dysfunction group was higher than that in pregnancy combined with normal thyroid function group P<0.05). Conclusion: Strengthening the screening of thyroid function of pregnant women and the management of high-risk factors can prevent adverse pregnancy outcomes and achieve good prenatal and postnatal care. |
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