摘要目的 探讨妊娠期甲状腺功能异常对产妇内分泌及胎儿合并症的影响.方法 选取本院于2014年1月至2015年12月期间收治的138例妊娠期甲状腺功能异常患者为研究对象,根据甲状腺功能异常类型分甲减组(甲状腺功能减退,74例)、甲亢组(甲状腺功能亢进,64例),另选取50例甲状腺功能正常产检孕妇为对照组.检测各组产妇空腹血糖(Fasting plasma glucose,FBG)、血脂[甘油三酯(Triglycerides,rG)、总胆固醇(Total cholesterol,TC)、高密度胆固醇(High density cholesterol,HDL-C)、低密度胆固醇(Low density cholesterol,LDL-C)]水平,观察胎儿合并症情况并进行比较.结果 甲减组TrG、TC、HDL-C水平均高于甲亢组、对照组,而FBG水平低于甲亢组、对照组,差异均有统计学意义(均P＜ 0.05);甲亢组TG、TC、HDL-C水平均低于对照组,而FBG水平高于对照组,差异均有统计学意义(均P＜ 0.05);亚临床甲减组、临床甲减组TG、TC、HDL-C水平均高于低甲状腺素血症组,差异均有统计学意义(均P＜ 0.05);甲减组、甲亢组胎儿合并症发病率分别为39.19％、35.94％,均高于对照组的16.00％,差异均有统计学意义(均P＜ 0.05).结论 妊娠期甲状腺功能减退会引起患者血糖水平下降,TG、TC、HDL-C水平上升,而妊娠期甲状腺功能亢进患者血糖、血脂水平的变化反之;妊娠期甲状腺功能异常会增加胎儿合并症的发病率.

abstractsObjective To investigate the effect of thyroid dysfunction in gestation period on internal secretion of pregnant women and fetal complications.Methods 138 patients with thyroid dysfunction in gestation period admitted into our hospital fiom January,2014 to December,2015 were selected as study objects.According to types of thyroid dysfunction,they were divided into a hypothyroid group (hypothyroidism,74 cases) and a hyperthyroidism group (hyperthyreosis,64 cases).And 50 pregnant women with normal thyroid function were selected as a control group.The levels of fasting plasma glucose (FBG),blood lipid [triglycerides (TG),total cholesterol (TC),high density cholesterol (HDL-C),low density cholesterol (LDL-C)] in all the groups were detected.The fetal complication was observed and compared.Results The levels of TG,TC,and HDL-C were higher and the FBG level was lower in the hypothyroid group than in hyperthyroidism group and the control group (P＜0.05).The levels of TG,TC,and HDL-C were lower and the FBG level was higher in the hyperthyroidism group than in the control group (P＜0.05).The levels of TG,TC,and HDL-C were higher in the subclinical hypothyroid group and the clinical hypothyroid group than in the hypothyroxinemia group (P＜0.05).The incidence of fetal complications was 39.19％ in the hypothyroid group and 35.94％ in hyperthyroidism group,which were higher than that in the control group (16.00％) (P＜0.05).Conclusions Hypothyroidism in gestation period will decrease patients' blood glucose level and increase the levels of TG,TC,and HDL-C,while the blood glucose and lipid levels of hyperthyroidism in gestation period are opposite.Thyroid dysfunction in gestation period will increase the incidence of fetal complications.