摘要
目的通过对妊娠7周内亚临床甲状腺功能减退症（甲减）妇女在妊娠全程的随访观察。确定妊娠期间甲状腺功能（甲功）的动态变化；分析该组人群在妊娠过程中的自然转归情况。方法85名妊娠7周（G7）内亚临床甲减妇女在G12-G36，每隔4周接受随访，应用固相化学发光酶免疫分析法检测血清TSH、TT4、FT4、TT3、FT3、TPOAb和TgAb。结果血清TSH水平在G12降至最低点（G12vsG6，P〈0．001），之后逐渐回升。血清TT4水平在G12时升至133．58nmol／L，之后至G32一直维持在高水平（与G6比较，都有P〈0．05）；G36时水平略有回降。血清FT4水平自妊娠早期开始逐渐下降（G16至G36各点与G6比较，都有P〈0．01）。血清TT3和FT3水平则在妊娠早期逐渐上升，妊娠中期和晚期水平相对稳定。G7内诊断的亚临床甲减妇女中，68．2％（58／85）在随访中至少有一个时点维持亚临床甲减（A组），31．8％（27／85）在随访期间血清TSH水平一直维持在正常范围内（B组）。A组和B组妊娠妇女的妊娠结局和新生儿的指标均差异无显著性。结论妊娠期间亚临床甲减妇女甲功随妊娠进展而变化；只有不足1／3的妊娠早期诊断的亚临床甲减妇女在整个随访期甲功可以自发恢复正常。
[Objective] To explore the dynamic changes of thyroid function of the pregnant women with subclinical hypothyroidism during the pregnancy, and to observe the outcome of subclinical hypothyroidism in these women during the pregnancy. [Methods] 85 pregnant women with subclinical hypothyroidism were followed up regularly from G12 to G36 and the interval was 4 weeks. All the subjects underwent the planned thyroid tests regularly. Serum TSH, TT4, FT4, TT3, TT3, TPOAb and TgAb were measured. [Results ] Serum TSH decreased to nadir at G12 （compared with G6, P 〈0.01） and then increased gradually. Serum TY4 increased to 133.58 nmol/L at G12, and remained the high level to G32. Serum ETa decreased gradually from the first trimester till the end of the pregnancy （each point from G16 to G36, P 〈0.01）. Serum TT3 and FT3 increased gradually in the first trimester, and stayed in the high level thereafter. 68.2% of pregnant women with subclinical hypothyroidism before G7 still presented subclinical hypothyroidism during the pregnancy （group A）. And the TSH level in only 31.8% of pregnant women with subclinical hypothyroidism decreased into the normal intervals during follow-up period （group B）. The pregnant outcomes and the indexes of newborns are not different between group A and group B. [ Conclusion ] The levels of serum TSH and thyroid hormones fluctuate during the different phases of pregnancy. The thyroid function can restore normal levels in less than one third of pregnant women with subclinical hypothyroidism diagnosed in early pregnancy.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2013年第1期61-65,共5页
China Journal of Modern Medicine
基金
公益性卫生行业科研专项项目(No:200802008)
辽宁省科学技术计划项目(No:2007225010)
