尚志容

【摘要】 目的：探究妊娠伴甲减患者不同时期治疗对新生儿结局影响。方法：选取2017年2月-2018年6月在笔者所在医院就诊的妊娠伴甲减患者79例，根据就诊时妊娠周期分为早期组（妊娠13周前）62例、非早期组（妊娠13周及以上）17例，两组患者就诊前均未接受甲减治疗;确诊后进行甲减针对性治疗。比较治疗效果、妊娠结局、新生儿结局。结果：治疗前两组TSH、FT3、FT4水平比较差异无统计学意义（P>0.05），治疗后早期组患者TSH、FT3、FT4水平均优于非早期组，差异均有统计学意义（P<0.05）;早期组妊娠不良结局发生率为17.7%，低于非早期组的41.2%，差异有统计学意义（P<0.05）;早期组新生儿不良结局发生率为1.6%，低于非早期组的17.7%，差异有统计学意义（P<0.05）。结论：对妊娠伴甲减患者早期治疗，可改善甲状腺功能、妊娠结局及新生儿结局，降低妊娠合并症发生率。

【关键词】 妊娠伴甲减 新生儿结局 早期治疗

doi：10.14033/j.cnki.cfmr.2019.28.022 文献标识码 B 文章编号 1674-6805（2019）28-00-03

The Influence of Early Treatment of Pregnancy with Hypothyroidism on Pregnancy Outcome and Neonatal Outcome/SHANG Zhirong. //Chinese and Foreign Medical Research， 2019， 17（28）： -56

[Abstract] Objective： To explore the effect of different periods of treatment on neonatal outcomes in pregnant women with hypothyroidism. Method： A total of 79 pregnant women with hypothyroidism were selected from February 2017 to June 2018. According to the pregnancy cycle at the time of consultation， they were divided into early group （62 cases before 13 weeks of pregnancy） and non-early group （17 cases after 13 weeks of pregnancy）. The patients in both groups did not receive hypothyroidism before seeing a doctor， and were treated with hypothyroidism after diagnosis. The therapeutic effect， pregnancy outcome and neonatal outcome were compared. Result： There were no significant differences in TSH， FT3 and FT4 level between the two groups before treatment （P>0.05）. After treatment， the levels of TSH， FT3 and FT4 in the early group were better than those in the non-early group （P<0.05）. The incidence of adverse pregnancy outcome in the early group was 17.7%， which was significantly lower than 41.2% in the non-early group， the difference was statistically significant （P<0.05）. The incidence of neonatal adverse outcome in the early group was 1.6%， which was lower than 17.7% in the non-early group， the difference was statistically significant （P<0.05）. Conclusion： Early treatment of pregnancy with hypothyroidism can improve thyroid function， pregnancy outcome and neonatal outcome， and reduce the incidence of pregnancy complications.

[Key words] Pregnancy with hypothyroidism Neonatal outcomes Early treatment

First-authors address： Mianyang Maternal and Child Health and Family Planning Service Center， Mianyang 621000， China

妊娠期甲减是妊娠常见合并症，发病原因复杂，包括原发性甲状腺功能减退、垂体、下丘脑病变引发的继发性甲状腺功能减退或甲状腺激素不敏感综合征等[1-2]。临床症状表现为怕冷、疲乏、嗜睡等，行动方面表现为皮肤苍白、行动迟缓、头发干枯等，但症状不明显，对孕妇影响较小，但会引发妊娠糖尿病、贫血、妊娠高血压等情况，可影響胎儿正常发育，可发生胎儿窘迫、早产、巨大儿、体质量过低等情况，并且可引发新生儿智力障碍，严重影响新生儿生命质量[3]。并且受甲减影响，患者可出现妊娠并发症，影响妊娠结局。为提升甲减治疗效果，减少不良妊娠结局及发育不良胎儿的发生，本研究将妊娠伴甲减患者分为早期组（妊娠13周前）和非早期组（妊娠13周及以上），探讨不同时期治疗对妊娠结局及新生儿发育的影响，具体如下。

1 资料与方法

1.1 一般资料

研究对象为2017年2月-2018年6月笔者所在医院收治的妊娠伴甲减患者79例。纳入……