标题：妊娠早期母体TSH水平异常对其妊娠结局的影响

      作者：贾学元，何恒君
    （都江堰市医疗中心，四川 都江堰 611830）

      卷次： 2012年23卷24期

      【摘要】 目的 探讨妊娠早期母体甲状腺（TSH）水平异常孕产妇的妊娠结局。方法 选择甲状腺功能亢
进患者44例列入甲亢组，甲状腺功能减退患者36例列入甲减组，经检查健康妊娠妇女40例列入对照组，所有患
者于妊娠期间行甲亢及甲减对症治疗，观察和记录三组孕妇妊娠后的母婴结局，并进行比较。结果 甲亢组与
甲减组母体发生妊高征、甲状腺危象、胎盘早剥、胎膜早破、心力衰竭、剖宫产等不良结局的比例明显高于对照
组，差异具有统计学意义（P<0.05）；除妊高征、甲状腺危象、产后出血，甲亢组患者发生率略高于甲减组（P<0.05），
其余结局两组差异无统计学意义（P>0.05）。甲亢组和甲减组围产儿结局低体重新生儿、自然流产、先兆子痫、早
产、重症监护发生率明显高于对照组，差异具有统计学意义（P<0.05）；甲亢组患儿除新生儿甲亢发生率明显高于
对照组和甲减组外（P<0.05），其余围产儿结局与甲减组差异无统计学意义（P>0.05）。结论 妊高征、甲状腺危
象、胎盘早剥、胎膜早破、心力衰竭等是妊娠早期母体TSH水平异常而发生的母体结局，低体重新生儿、自然流
产、先兆子痫、早产等是TSH水平异常所造成的主要围产儿不良结局，应早期发现孕妇的TSH水平异常情况，有
效控制和改善，并在妊娠期间内做好一系列治疗与护理工作。

      【关键词】 妊娠早期；甲状腺激素；妊娠结局；临床影响

      【中图分类号】 R714.14 【文献标识码】 A 【文章编号】 1003—6350（2012）24—064—03<

br>Influence of abnormal TSH levels in the matrix in early pregnancy on the pregnancy outcome.
JIA Xue-yuan,
HE Heng-jun. Medical Center of Dujiangyan City, Dujiangyan 611830, Sichuan,CHINA

【Abstract】 Objective To study and analyze the influence of abnormal thyroid (TSH) levels in the matrix in
early pregnancy on pregnancy outcome. Methods Forty-four patients with hyperthyroidism were enrolled as the hy-
perthyroidism group, and 36 patients with hypothyroidism were enrolled as the hypothyroidism group. Forty healthy
pregnant women were selected as the control group. The patients all received corresponding treatment. The pregnancy
outcome were recorded and compared between the three groups. Results The incidences of pregnancy-induced
hypertension syndrome, thyroid storm, placental abruption, premature rupture of membranes, heart failure, cesare-
an section were significantly higher in the hyperthyroidism group and the hypothyroidism group than the control
group (P<0.05). The incidences of pregnancy-induced hypertension syndrome, thyroid storm, postpartum hemorrhage
in the hyperthyroidism group were slightly higher than those in the hypothyroidism group (P<0.05), while the inci-
dence of other maternal outcome showed no statistically significant difference between the two groups (P>0.05). The
incidences of low birth weight, spontaneous abortion, preeclampsia, preterm delivery, intensive care were significantly
higher in the hyperthyroidism group and the hypothyroidism group than the control group (P<0.05). The inci-
dence of hyperthyroidism in the hyperthyroidism group was significantly higher than that in the hypothyroidism
group, while other perinatal outcomes showed no statistically significant difference between the two groups (P>
0.05). Conclusion Pregnancy-induced hypertension syndrome, thyroid storm, placental abruption, premature rup-
ture of membranes are the maternal outcomes caused by abnormal TSH levels, and low birth weight, spontaneous abor-
tion, preeclampsia, preterm delivery are the perinatal outcomes.

      【Key words】 Early pregnancy; Thyroid hormone; Pregnancy outcome; Clinical effects