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目的:探讨妊娠晚期亚临床甲减及TPO-Ab对妊娠结局的影响。方法:回顾性分析2011年8月至2013年2月湖南省人民院109名孕妇的病历资料。亚临床甲减组(A组)42例,其中TPO-Ab阳性(A1组)6例,TPO-Ab阴性(A2组)36例;正常对照组(B组)67例,其中TPO-Ab阳性(B1组)12例,TPO-Ab阴性(B2组)55例。分析其年龄、心率等一般资料,空腹血糖、甲状腺功能及TPO-Ab等生化指标,评估母亲和胎儿合并症。结果:1.亚临床甲减组平均心率较正常对照组偏低,差异有统计学意义,但两组在其他一般情况、生化指标、孕妇代谢指标及新生儿出生时情况等方面的无明显差异。2.亚临床甲减组较正常对照组胎儿合并症及胎儿窘迫发生风险均增加,差异有统计学意义,但两组母亲合并症没有区别。3.亚临床甲减合并TPO-Ab阳性组与合并TPO-Ab阴性组比较,母亲合并症、胎儿合并症、胎膜早破、胎儿窘迫、早产的发生率均升高,且差异有统计学意义。结论:妊娠晚期亚临床甲减,尤其是合并有TPO-Ab阳性者是妊娠的高危因素,可导致不良妊娠结局发生率增高。
Objective: To investigate the effect of subclinical hypothyroidism and TPO-Ab on pregnancy outcome in late pregnancy. Methods: The clinical data of 109 pregnant women from Hunan Provincial People’s Hospital from August 2011 to February 2013 were retrospectively analyzed. There were 42 cases in sub-clinical hypothyroidism group (group A), including 6 cases of TPO-Ab positive (group A1) and 36 cases of negative TPO-Ab (group A2); 67 cases of normal control group (group B) (B1 group), TPO-Ab negative (B2 group) 55 cases. Analysis of general information such as age, heart rate, fasting blood glucose, thyroid function and TPO-Ab and other biochemical indicators to assess maternal and fetal complications. The average heart rate in subclinical hypothyroidism group was lower than the normal control group, the difference was statistically significant, but there was no significant difference between the two groups in other general conditions, biochemical indexes, metabolic indexes of pregnant women and the newborn’s birth . Clinical subclinical hypothyroidism group than the normal control group, fetal complications and fetal distress risk increased, the difference was statistically significant, but there was no difference between the two groups of maternal complications. 3. The incidence of maternal complications, fetal complications, premature rupture of membranes, fetal distress and premature labor in subclinical hypothyroidism combined with TPO-Ab positive group was significantly higher than that in combined TPO-Ab negative group significance. CONCLUSIONS: Subclinical hypothyroidism in late pregnancy, especially those with positive TPO-Ab, is a risk factor for pregnancy and can lead to an increased incidence of adverse pregnancy outcomes.