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目的观察甲亢和甲减病人合并妊娠生产后,婴儿的甲功变化,智力异常,和早期干预治疗后对婴幼儿智力障碍的补偿作用。方法对2010-2016年在吉林市中心医院妇产科、内分泌科就诊的甲功异常的妊娠妇女,共151名,孕妇在G12和G24分别测FT3、FT4、TSH、TPO、TG-ab。婴儿在出生时,6个月,12个月,分别检查甲功五项和运动、智力评分。结果甲亢组和甲减组妊娠妇女经干预治疗G12和G24时,甲功趋于正常,FT_3、FT_4、TSH水平无明显差异。甲亢组婴儿出生时TSH明显升高,其水平与其他两组比较P<0.05,差异有统计学意义,各组孕妇后代神经智力发育及运动评分的比较MDI和PDI,甲亢组MDI和PDI水平有所下降,但后期上升明显,各组有所差别,但无统计学意义。我们早期干涉后婴儿的甲功和神经智力发育及运动评分明显上升,与健康对照组无显著差异。结论孕母甲功异常可以影响子代的甲状腺功能,使子代的智能发育受影响。甲亢组不良妊娠明显增多,孕妇甲功异常的及时干预治疗,子代甲功的及时调整,可以子代的智力评分和运动评分绝对值上升,对其子代的智力障碍有补偿作用。
Objective To observe the compensatory effects of thyroid dysfunction, mental retardation and infant mental retardation after hyperthyroidism and hypothyroidism combined with pregnancy. METHODS: A total of 151 pregnant women with abnormal thyroid function were treated in Gynecology and Endocrinology Department of Jilin Central Hospital from 2010 to 2016. Pregnant women measured FT3, FT4, TSH, TPO and TG-ab in G12 and G24, respectively. Infants at birth, 6 months, 12 months, respectively, check five exercises and exercise, mental score. Results In hyperthyroidism group and hypothyroidism group, the thyroid function tended to be normal and the levels of FT_3, FT_4 and TSH were not significantly different in pregnant women treated with G12 and G24. TSH in hyperthyroidism group was significantly higher at birth than that in the other two groups (P <0.05), and the difference was statistically significant. Neuropsychological development and motor score of the offspring in each group were compared between MDI and PDI, MDI and PDI in hyperthyroidism group were Decreased, but the latter increased significantly, each group differences, but no statistical significance. After early intervention, the scores of AQ and neuro-intelligence and motor scores in infants were significantly increased, which were not significantly different from those in healthy controls. Conclusion Abnormal gestational maternal thyroid function can affect offspring thyroid function, so that the offspring of intelligent development affected. Hyperthyroidism group significantly increased unhealthy pregnancy, pregnant women with abnormal thyroid function timely intervention treatment, offspring of the timely adjustment of thyroid function, the offspring of intelligence score and exercise score absolute rise, the offspring of mental retardation compensation role.