妊娠期甲状腺功能减低症的筛查与转归.docVIP

精品论文 参考文献 妊娠期甲状腺功能减低症的筛查与转归 刘莉 关阿娜 夏丽秀 ( 包头医学院第二附属医院妇产科 0 1 4 0 3 0 ) 　　【摘要】目的 探讨妊娠期甲状腺功能减低症（简称甲减）筛查的意义，观察妊娠期甲减患者的妊娠结局。方法 测定230 例妊娠妇女的血清促甲状腺激素（TSH）、甲状腺过氧化物酶抗体(TPOAb)、游离甲状腺素(FT4)，甲减患者应用药物治疗，严密监测甲状腺功能和胎儿宫内生长，并将妊娠结局及对母儿影响与200 例正常孕妇比较。结果 妊娠合并甲减经药物治疗及严密监测后，母儿结局良好，出生平均体重低于对照组，胎膜早破，剖宫产率低于对照组(Plt;0.05)，早产，小于胎龄儿，围产儿死亡，出生缺陷，新生儿窒息，新生儿甲状腺功能异常，妊娠期高血压疾病，产后出血发生率与对照组无统计学差异( P gt;0.05)。结论妊娠期甲减的筛查具有重要意义，妊娠合并甲减患者如能及时甲状腺替代治疗，能明显改善围产结局。 　　【关键词】 妊娠 甲状腺功能减低症 筛查 妊娠结局【Abstract】Objective Stady of thyroid function in pregnancy reduction (referred to as hypothyroidism) screening the significance, pregnancy outcome of gestational hypothyroidism.Methods Determination of 230 cases of pregnant womens serum thyroid stimulating hormone（TSH）,thyroid peroxidase antibody(TPOAb),free thyroxine(FT4), application of drug treatment inpatients with hypothyroidism, close monitoring of thyroid function and fetal growth, and the pregnancy outcome and the influence on mothers and infants and 200 cases of normal pregnantwomen compared. Results After the drug treatment and close monitoring after preguancy complicated with hypothyroidism, maternal and pregnancy outcome was good, the average bodyweight was lower than the control group, premature rupture of membranes, the cesarean section rate was lower than the control group (Plt;0.05), preterm delivery, small for gestationalage, perinatal death, birth defects, neonatal asphyxia, neonatal thyroid dysfunction, hyperteasive disorder complicating pregnancy, the incidence rate of postpartum hemorrhage and thecontrol group had no statistical difference (Plt;0.05).Conclusion Has an important significance in screening for gestational hypothyroidism, pregnant women with hypothyroidism can timely thyroidreplacement therapy, can significantly improve the perinatal outcome.【Key words】Pregnancy Hypothyroidism Screening The outcome of pregnancy【中图分类号】R714.25 【文献标识码】A 【文章编号】1672-5085（2013）36-0032-01甲状腺功能减低症是妊娠期一种常见的内分泌疾病之一，根据血清甲状腺激素水平可分为：临床甲减、亚临床甲减、孤立的低T4 血症和甲状腺自身抗体阳性，妊娠合并甲减导致妊