标题：妊娠合并甲状腺功能减退与新生儿甲减的关系

      作者：陈晓文，黄慧敏，卢淑彩    (深圳市人民医院产科，广东 深圳 518020)

      卷次： 2018年29卷14期

      【摘要】 目的 探讨妊娠合并甲状腺功能减退(简称妊娠期甲减)与新生儿甲减的关系。方法 选取2016年10月1日至2017年1月1日深圳市人民医院产科收治的177例妊娠期甲减患者为观察组，选取同期120例甲状腺功能正常的孕产妇为对照组，观察组患者统一采用左旋甲状腺激素(L-T4)治疗，依据治疗后促甲状腺素(TSH)达标率分为达标组(61例)和未达标组(116例)，分析三组产妇新生儿甲减的发生情况。结果 TSH未达标组患者TSH水平在妊娠早期、中期、晚期分别为(2.681±1.382) mIU/mL、(2.965±1.932) mIU/mL、(3.515±2.012) mIU/mL，均明显高于达标组[(2.326±0.534) mIU/mL、(2.014±0.546) mIU/mL、(2.031±0.516) mIU/mL]和对照组[(2.152±0.653) mIU/mL、(2.201±0.416) mIU/mL、(2.205±0.673) mIU/mL]，差异均有统计学意义(P<0.05)；TSH未达标组患者的FT4、FT3、T3、T4在妊娠早期、中期、晚期水平均低于达标组和对照组产妇，差异均有统计学意义(P<0.05)；达标组与对照组间TSH、FT4、FT3、T3、T4比较差异均无统计学意义(P>0.05)；观察组产妇的新生儿甲减检出率为 8.475%，对照组为 0，两组比较差异有统计学意义(P<0.05)；达标组产妇的新生儿甲减检出率为 1.724%，与对照组的 0比较差异无统计学意义(P>0.05)。结论 妊娠期甲减可导致新生儿甲减，孕期进行干预可显著改善孕妇甲状腺功能，降低新生儿甲减患病率。
      【关键词】 妊娠；甲状腺功能减退；新生儿；促甲状腺激素
      【中图分类号】 R714.256 【文献标识码】 A 【文章编号】 1003—6350（2018）14—1975—03

Relationship between pregnancy combined with hypothyroidism and hypothyroidism of the newborn.
CHENXiao-wen, HUANG Hui-min, LU Shu-cai. Department of Obstetrics and Gynecology, Shenzhen People's Hospital, Shenzhen518020, Guangdong, CHINA
【Abstract】 Objective To investigate the relationship between pregnancy combined with hypothyroidism andhypothyroidism in newborns. Methods A total of 177 cases of gestational hypothyroidism admitted in Shenzhen Peo-ple's Hospital from October 1, 2016 to January 1, 2017 were selected as the research group. Meantime, 120 cases of nor-mal thyroid function of pregnant women were chosen as the control group. The patients in the research group adopted levo-thyroxine (L-T4) treatment, who was further divided into the standard group (61 cases) and the non-standard group (116cases) according to the standard rate of thyroid stimulating hormone (TSH) after treatment. The occurrence of maternalneonatal hypothyroidism in three groups was analyzed. Results The level of TSH in the non-standard group was(2.681±1.382) mIU/mL, (2.965±1.932) mIU/mL and (3.515±2.012) mIU/mL in the early, middle and late trimester ofpregnancy, which were significantly higher than corresponding (2.326±0.534) mIU/mL, (2.014±0.546) mIU/mL, (2.031±0.516) mIU/mL in the standard group and corresponding (2.152 ± 0.653) mIU/mL, (2.201 ± 0.416) mIU/mL, (2.205 ±0.673) mIU/mL in control group (P<0.05). The levels of FT4, FT3, T3 and T4 in the non-standard group in the early, mid-dle and late trimester of pregnancy were significantly lower than those in the standard group and the control group (P<0.05). There was no significantly difference between the standard group and the control group in TSH, FT4, FT3, T3 andT4 (P>0.05). The detection rate of neonatal hypothyroidism was 8.475% in the research group versus 0 in the controlgroup (P<0.05); the detection rate of neonatal hypothyroidism was 1.724% in the standard group versus 0 in the controlgroup (P>0.05). Conclusion Hypothyroidism in pregnancy can lead to hypothyroidism, and intervention during pregnan-cy can significantly improve the thyroid function of pregnant women and reduce the incidence of hypothyroidism.
      【Key words】 Pregnancy; Hypothyroidism; Newborns; Thyroid stimulating hormone (TSH)·论 著·doi:10.3969/j.issn.1003-6350.2018.14.016