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目的探讨甲状腺功能及抗体筛查对孕妇妊娠结局的影响。方法 2012-10/2013-10月对750例孕妇行产前甲状腺功能筛查,另选取750名非妊娠妇女为对照组,分别采用免疫吸附法测定两组甲状腺过氧化酶抗体(thyroid peroxidase antibody,TPOAb)、促甲状腺素(thyrotropin,TSH)、总甲状腺素(total thyroxine,TT4)、血清游离甲状腺素(serum free thyroxine,FT4)、游离三碘甲腺原氨酸(free triiodothyronine,FT3)以及总三碘甲腺原氨酸(total triiodothyronine,TT3)水平。结果 750例孕妇中共发现甲状腺功能亢进(甲亢)78例(10.40%),甲状腺功能减退(甲减)62例(8.27%),TPOAb阳性25例(3.33%),而对照组中甲亢12例(1.60%)、甲减8例(1.07%),TPOAb阳性78例(10.40%),两组甲亢、甲减及TPOAb阳性率具有统计学差异(P<0.05)。与正常妊娠组相比,甲减组患者早产、妊娠高血压、孕期贫血、孕期低体重、胎儿窘迫、孕期糖代谢异常发生率显著升高(P<0.05),而甲亢组患者子痫前期、孕期心脏病、流产、早产、胎儿窘迫、新生儿生长受限发生率显著升高,差异有统计学意义(P<0.05)。结论与正常妇女相比,妊娠妇女甲状腺功能异常发生率较高,应引起孕妇及医生的重视。妊娠期甲状腺功能异常患者不良妊娠结局发生率较高,因此临床工作者应重视妊娠期甲状腺功能筛查,做到早筛查,早诊治,以改善患者妊娠结局。
Objective To investigate the effect of thyroid function and antibody screening on pregnant women’s pregnancy outcome. Methods Prenatal thyroid function screening was performed on 750 pregnant women from July 2012 to October 2013. A total of 750 nonpregnant women were selected as the control group. The levels of thyroid peroxidase antibody TPOAb, thyrotropin (TSH), total thyroxine (TT4), serum free thyroxine (FT4), free triiodothyronine (FT3) Total triiodothyronine (TT3) levels. Results Among the 750 pregnant women, there were 78 cases (10.40%) of hyperthyroidism, 62 cases (8.27%) of hypothyroidism (hypothyroidism) and 25 cases (3.33%) of TPOAb positive in control group, while 12 cases of hyperthyroidism 1.60%), hypothyroidism in 8 cases (1.07%) and TPOAb positive in 78 cases (10.40%). The positive rates of hyperthyroidism, hypothyroidism and TPOAb were statistically different between the two groups (P <0.05). Compared with normal pregnancy group, the incidence of premature delivery, pregnancy-induced hypertension, anemia during pregnancy, low body weight during pregnancy, fetal distress and abnormal glucose metabolism during pregnancy were significantly higher in hypothyroidism group (P <0.05) Pregnancy heart disease, abortion, premature birth, fetal distress, neonatal growth restriction increased significantly, the difference was statistically significant (P <0.05). Conclusion Compared with normal women, the incidence of abnormal thyroid function in pregnant women is higher, which should be paid more attention to by pregnant women and doctors. Patients with abnormal thyroid function during pregnancy have a higher prevalence of adverse pregnancy outcomes. Therefore, clinicians should pay attention to thyroid function screening during pregnancy so as to make early screening and early diagnosis and treatment to improve the pregnancy outcome.