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目的研究激素替代治疗妊娠合并甲状腺功能减退症(甲减)对妊娠结局的影响。方法回顾分析我院妇产科于2013年1月-2015年6月期间收治的妊娠合并甲减患者165例,其中,89例亚临床甲减为SCHO组,76例临床甲减为OH组,均接受规范性甲状腺激素替代治疗,并选择同期健康妊娠孕妇100例作为对照组。比较三组的妊娠结局。结果OH组的胎膜早破率为21.05%,高于对照组的9.00%(P<0.05),但与SCHO组的13.48%比较差异无统计学意义(P>0.05);OH组的剖宫产率为77.63%,高于SCHO组的52.81%和对照组的50.00%(P<0.05);三组妊娠期糖尿病、妊娠期高血压、羊水过少、产后出血发生率比较差异无统计学意义(P>0.05)。三组的早产率、新生儿窒息及低出生体重儿发生率比较均无统计学意义(P>0.05)。结论规范性激素替代治疗妊娠合并甲减能够有效维持或改善甲状腺功能,减少甲状腺自身抗体对于妊娠结局所致不良影响,争取与健康妊娠孕妇相当的妊娠结局。
Objective To study the effect of hormone replacement therapy on pregnancy outcome in pregnancy with hypothyroidism (hypothyroidism). Methods A retrospective analysis of our hospital obstetrics and gynecology in January 2013 -2015 in June period in 165 cases of pregnancy with hypothyroidism, of which 89 cases of subclinical hypothyroidism for the SCHO group, 76 cases of clinical hypothyroidism OH group, All received standardized thyroid hormone replacement therapy, and select the same period of 100 healthy pregnant women as a control group. Comparison of three groups of pregnancy outcomes. Results The rate of premature rupture of membranes in OH group was 21.05%, which was higher than that in control group (9.00%, P <0.05), but there was no significant difference compared with that in SCHO group (P> 0.05) The rate of gestational diabetes mellitus, gestational hypertension, oligohydramnios and the incidence of postpartum hemorrhage was no significant difference among the three groups (77.63% vs 52.81% in the SCHO group and 50.00% in the control group (P <0.05) (P> 0.05). The three groups of preterm birth rate, neonatal asphyxia and low birth weight infants incidence comparison was not statistically significant (P> 0.05). Conclusion Normative hormone replacement therapy for pregnancy combined with hypothyroidism can effectively maintain or improve thyroid function, reduce the adverse effects of thyroid autoantibodies on pregnancy outcomes, and strive for the same pregnancy outcomes with healthy pregnant women.