亚临床甲状腺功能减退症孕妇出生婴儿智力评估

古东海何小洁王艳丽

(茂名市人民医院内分泌科， 广东 茂名 525000)

【摘要】目的探讨妊娠期患亚临床甲状腺功能减退症孕妇对出生婴儿甲状腺功能水平及智力的影响。方法选取收治的50例妊娠期亚临床甲状腺功能减退(孕甲减)孕妇及同期50例健康孕妇出生的婴儿，孕甲减出生婴儿为观察组，健康孕妇出生婴儿的对照组。分别测定两组婴儿在新生儿期、1岁、2岁时甲状腺功能及智力水平，对所得结果进行统计学分析及比较。结果两组婴儿中，观察组血清促甲状腺激素(TSH)水平明显高于对照组，血清 FT4、FT3水平则明显低于对照组，差异均具统计学意义(P<0.01)。1年、2年时期比较中，两组TSH、FT4、FT3水平差异无显著统计学意义 (P>0. 05)。两组婴儿在出生时及1岁、2岁时，观察组发育商均低于对照组，差别有统计学意义 (P<0.05)。 结论女性妊娠期亚临床甲状腺功能减退对其婴儿的智力发育、甲状腺功能均有一定程度的影响，及时、定期筛查并积极治疗妊娠期亚临床甲状腺减退症对优生优育具有重要意义；对患有甲状腺功能减退症的孕妇及其婴儿加强管理、科学规范治疗十分必要。

【关键词】亚临床甲状腺功能减退症； 孕妇； 婴儿； 甲状腺功能； 智力评估

【中图分类号】R 582`+.2

【文献标志码】A

doi：10.3969/j.issn.1672-3511.2015.10.038

Abstract【】ObjectiveTo observe the thyroid function level and intelligence of infants born to the pregnancy with subclinical hypothyroidism. Methods50 infants born to gravidas with subclinical hypothyroidism treated in our hospital and 50 infants born to healthy gravidas from July 2009 to July 2012 were selected and divided into two groups, the observation group and the control group. The thyroid function level and intelligence in neonatal stage, 1 year old and 2 years old of two groups of infants was respectively determined. And the results were analyzed and compared. ResultsFor the infants in two groups, TSH level in the observation group was higher evidently than that in the control group, but serum FT4 and FT3 level were lower evidently in the observation group were lower evidently than that in the control group, which had statistical significance (P<0.01). For the comparison of 1 year old and 2 years old, there was no evident difference for TSH, FT4 and FT3 level between two groups (P>0.05). During neonatal stage, 1 year old and 2 years old, the development quotient of the observation group was lower than that of the control group, which had statistical significance (P<0.05). ConclusionSubclinical hypothyroidism for gravida has influence on the intelligence and thyroid function of infants. Timely and regular screening and positive treatment on gestational subclinical hypothyroidism has great significance for prenatal and postnatal care. It is necessary to enhance management, scientific and standardized treatment on gravida with subclinical hypothyroidism.

收稿日期：( 2014-04-04； 编辑： 陈舟贵)

IntelligenceevaluationofinfantsborntogravidawithsubclinicalhypothyroidismGUDonghai,HEXiaojie,WANGYanli

(The People’s Hospital of Maoming, Maoming 525000, Guangdong, China)

【Keywords】Subclinicalhypothyroidism；Gravida；Infant；Thyroidfunction；Intelligenceevaluation

亚临床甲状腺功能减退症是指患者的血清促甲状腺激素(TSH)增高，TT4和FT4正常，其对妊娠结局以及后代的智力发育、甲状腺功能所带来的影响是目前内分泌学、优生优育学共同关注的研究热点[1]。有资料显示[2]，妊娠妇女亚临床甲状腺功能减退症 (亚甲减) 患病率约为3%～4%，而流行病学资料则显示，后代智力发育受损情况及甲状腺功能、运动发育指数下降与母亲妊娠期甲状腺功能低下密切相关。国外学者Haddow等人曾报道[3]妊娠期女性患亚临床甲状腺功能减退可能造成其婴儿智力发育低下、甲状腺功能减退等。……