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目的探讨妊娠期母体血清甲状腺激素水平动态变化特征及其与妊娠结局间的关系。方法收集2012年1月-2013年12月,本院门诊及住院孕妇570例作为观察组,选择同期体检非妊娠期健康妇女120例作为对照组,采用化学发光分析仪检测对照组与观察组孕早期(84例)、孕中期(177例)和孕晚期(309例)的血清甲状腺激素水平;追踪随访观察组的妊娠结局。结果妊娠期母体血清T3、T4显著升高(P<0.05),FT3及FT4水平有降低趋势(P>0.05),TSH水平较非妊娠状态显著降低(P<0.05),以妊娠早期最低,此后呈增高的趋势;观察组SCH、TPOAb阳性和低T4血症发生率为7.89%、14.91%、7.72%;SCH与TPOAb阳性组不良妊娠结局发生率显著高于甲状腺功能正常组(P<0.05),而低T4血症组与甲状腺功能正常组差异无统计学意义(P>0.05)。结论妊娠期母体内血清甲状腺激素水平具有规律性变化,轻度甲减与不良妊娠结局密切相关,动态监测妊娠期血清甲状腺激素水平变化,对于及时筛查母体甲状腺功能异常及妊娠结局预测具有重要意义。
Objective To investigate the dynamic changes of serum thyroid hormone level in pregnancy and its relationship with pregnancy outcome. Methods From January 2012 to December 2013, 570 outpatient and inpatient pregnant women in our hospital were selected as the observation group, and 120 healthy non-pregnant healthy women were selected as the control group during the same period. The chemiluminescence analyzer was used to test the control group and observation group Serum thyroid hormones were detected in early stage (84 cases), middle stage (177 cases) and third trimester (309 cases). The follow-up observation group’s pregnancy outcome was followed up. Results The serum levels of T3 and T4 in pregnant women were significantly increased (P <0.05), FT3 and FT4 levels were decreased (P> 0.05), TSH levels were significantly lower than those in non-pregnant women (P <0.05) (P <0.05). The incidences of SCH, TPOAb-positive and hypo-T4mia in the observation group were 7.89%, 14.91% and 7.72% respectively. The incidence of adverse pregnancy outcomes in SCH and TPOAb positive group was significantly higher than that in normal thyroid function group (P <0.05) , While there was no significant difference between low T4 blood group and normal thyroid function group (P> 0.05). Conclusion The level of serum thyroid hormone in pregnant women has regular changes. Mild hypothyroidism is closely related to the outcome of adverse pregnancy. Dynamic monitoring of serum thyroid hormone levels during pregnancy is of great significance for the timely screening of maternal thyroid dysfunction and pregnancy outcome prediction .