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目的探讨亚临床甲状腺功能减退(SCH)对妊娠期疾病及代谢状态的影响。方法选取2013年1月-2015年12月在沧州市人民医院产科孕检并发SCH的孕妇424例作为研究组,选择同期血清促甲状腺素(TSH)水平正常的孕妇613例作为对照组。观察两组孕妇在妊娠期发生的合并症、并发症情况、糖化血红蛋白(Hb A1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HCL-C)、尿酸(UA)及尿微量白蛋白(m Alb)等代谢指标水平。结果 (1)研究组患者发生妊娠期糖尿病203例(47.88%)、妊娠期高血压疾病83例(19.10%)、贫血174例(41.04%)、胎盘早剥15例(3.54%),并发症发生率明显高于对照组孕妇,差异有统计学意义(P<0.05),胎膜早破及前置胎盘发生情况组间比较,差异均没有统计学意义(均P>0.05);(2)研究组患者HbA1c(7.64±1.92)%、TG(2.03±1.25)mmol/L、TC(5.03±1.27)mmol/L、LDL-C(2.27±0.18)mmol/L、HCL-C(1.89±0.42)mmol/L、UA(352.72±54.26)μmol/L及mAlb(45.82±21.63)mg/L,与对照组孕妇比较,差异均有统计学意义(均P<0.05)。结论 SCH能够增加孕妇患妊娠期糖尿病和妊娠期高血压等疾病的风险,并且影响糖代谢、脂代谢以及尿酸代谢。
Objective To investigate the effect of subclinical hypothyroidism (SCH) on the disease and metabolic status during pregnancy. Methods A total of 424 pregnant women with SCH during obstetric and gynecological pregnancy examination in Cangzhou People’s Hospital from January 2013 to December 2015 were selected as the study group and 613 pregnant women with normal thyroid hormone (TSH) level during the same period were selected as the control group. The complications, complications, Hb A1c, TG, TC, LDL-C, HDL-C of the two groups of pregnant women during pregnancy were observed. (HCL-C), uric acid (UA) and urinary microalbumin (m Alb) and other metabolic indicators. Results (1) In the study group, 203 cases (47.88%) had gestational diabetes mellitus, 83 cases (19.10%) had gestational hypertension, 174 cases (41.04%) had anemia, 15 cases (3.54%) had placental abruption, (P <0.05), premature rupture of membranes and placenta previa, there were no significant differences between the two groups (all P> 0.05); (2) The levels of HbA1c in the study group were (7.64 ± 1.92)%, TG (2.03 ± 1.25) mmol / L and TC (5.03 ± 1.27) mmol / L and LDL-C ) mmol / L, UA (352.72 ± 54.26) μmol / L and mAlb (45.82 ± 21.63) mg / L respectively. There were significant differences between the two groups (P <0.05). Conclusions SCH can increase the risk of developing gestational diabetes and gestational hypertension among pregnant women, and also affect glucose metabolism, lipid metabolism and uric acid metabolism.