摘要
目的探讨早发型和晚发型重度子痫前期患者妊娠晚期甲状腺激素水平及母婴结局差异。方法选择2017年1月至2018年1月于郑州大学第三附属医院住院分娩的重度子痫前期患者425例为研究对象,其中早发型重度子痫前期259例(早发型组),晚发型重度子痫前期166例(晚发型组);并选同期202例非子痫前期分娩孕妇作为对照组。所有入选者均于入院次日清晨抽取空腹静脉非抗凝血,检测血清促甲状腺素(TSH)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPOAb)水平,比较3组受试者甲状腺功能异常情况;并根据甲状腺功能评价结果,将重度子痫前期患者分为早发型甲状腺功能正常组、早发型甲状腺功能异常组、晚发型甲状腺功能正常组和晚发型甲状腺功能异常组,比较早发型甲状腺功能正常组与早发型甲状腺功能异常组以及晚发型甲状腺功能正常组与晚发型甲状腺功能异常组母体并发症及围产儿结局。结果 3组受试者血清TSH、FT4水平比较差异有统计学意义(χ~2=60.680、39.951,P<0.05),TPOAb阳性率比较差异无统计学意义(χ~2=1.599,P>0.05)。早发型组和晚发型组患者血清TSH水平显著高于对照组(Z=-7.177、-6.071,P<0.05),血清FT4水平显著低于对照组(Z=-4.858、-5.975,P<0.05)。晚发型组与早发型组患者比较,血清TSH水平显著降低(Z=-6.071,P<0.05),FT4水平比较差异无统计学意义(Z=-1.543,P>0.05)。3组受试者甲亢/亚临床甲亢、单纯性TPOAb阳性发生率比较差异无统计学意义(χ~2=0.650、0.187,P>0.05); 3组受试者甲减/亚临床甲减、低甲状腺素血症发生率以及甲状腺功能异常发生率比较差异有统计学意义(χ~2=52.841、12.912、66.766,P<0.05)。早发型组和晚发型组患者甲减/亚临床甲减、低甲状腺素血症、甲状腺功能异常发生率显著高于对照组(χ~2=53.506、9.399、64.506、26.767、12.647、38.528,P<0.05)。早发型组患者甲减/亚临床甲减发�
Objective To investigate the difference of thyroid hormone level and pregnancy outcomes between the patients with early-onset and late-onset severe preeclampsia. Methods A total of425 patients with severe preeclampsia admitted to the Third Affiliated Hospital of Zhengzhou University from January2017 to January2018 were selected as the study objects,including259 cases of early-onset severe preeclampsia (early-onset group) and166 cases of late-onset severe preeclampsia (late-onset group).A total of202 pregnant women without preeclampsia were selected as the control group in the same period.Non-anticoagulant fasting venous blood were taken from all the pregnant women in the next morning after admission to detect the levels of serum thyrotropin (TSH), free thyroxine (FT4) and thyroid peroxidase antibody (TPOAb), and compare the thyroid dysfunction among the three groups.The patients with severe preeclampsia were divided into early-onset normal thyroid function group,early-onset thyroid dysfunction group ,late-onset normal thyroid function group and late-onset thyroid dysfunction group according to the results of thyroid function evaluation.Maternal complications and perinatal infant outcomes were compared between early-onset normal thyroid function group and early-onset thyroid dysfunction group,late-onset normal thyroid function group and late-onset thyroid dysfunction group. Results There was significant difference in the levels of serum TSH,FT4 and the positive rate of TPOAb among the three groups (χ^2=60.680, 39.951,1.599;P <0.05).The serum TSH level in the early-onset group and late-onset group was significantly higher than that in the control group ( Z =-7.177,-6.071;P <0.05),and the serum FT4 level in the early-onset group and late-onset group was significantly lower than that in the control group ( Z =-4.858,- 5.975;P <0.05).The serum TSH level in the late-onset group was significantly lower than that in the early-onset group ( Z =-6.071 , P <0.05).There was no significant difference in serum FT4 level betwe
作者
刘金金
崔世红
韩笑
魏天翔
吕晓峰
LIU Jin-jin;CUI Shi-hong;HAN Xiao;WEI Tian-xiang;LYU Xiao-feng(Department of Obstetrics,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)
出处
《新乡医学院学报》
CAS
2019年第5期459-463,共5页
Journal of Xinxiang Medical University
关键词
早发型
晚发型
重度子痫前期
促甲状腺激素
甲状腺激素
母婴结局
early onset
late-onset
severe preeclampsia
thyroidstimulating hormone
thyroid hormone
pregnancy outcome
