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目的:探讨亚临床甲状腺功能减退(SCH)对GDM病情的影响程度。方法:选取2013年4月~2014年8月于我院就诊的GDM合并SCH孕妇共244例(研究组),根据孕妇及非孕人群血清TSH的正常值上限,将其中110例TSH>4.0m U/L者归为研究组A,134例TSH 2.5~4.0m U/L者归为研究组B。另取同期就诊的甲状腺功能正常的GDM孕妇120例作为对照组。分析3组患者的临床资料。结果:3组孕妇的空腹血糖、糖化血红蛋白、糖化血清蛋白等比较,差异均无统计学意义(P>0.05)。但研究组孕妇的胰岛素使用率均高于对照组,胰岛素敏感指数(ISI)和胰岛分泌功能指数(IFI)则低于对照组(P<0.05)。结论:合并SCH的GDM孕产妇,其胰岛功能受损情况更为严重,使用胰岛素的概率升高。
Objective: To investigate the impact of subclinical hypothyroidism (SCH) on the severity of GDM. Methods: A total of 244 pregnant women with GDM and SCH were enrolled in our hospital from April 2013 to August 2014. According to the upper limit of normal serum TSH in pregnant women and non-pregnant women, 110 cases with TSH> 4.0m U / L were classified as study group A, 134 cases of TSH 2.5 ~ 4.0m U / L were classified as study group B. Another 120 cases of GDM pregnant women with normal thyroid function during the same period were taken as control group. Clinical data of 3 groups were analyzed. Results: There was no significant difference in fasting blood glucose, glycosylated hemoglobin and glycosylated serum protein between the three groups of pregnant women (P> 0.05). However, the pregnant women in the study group had higher insulin use rate than those in the control group, and insulin sensitivity index (ISI) and islet secretion function index (IFI) were lower than those in the control group (P <0.05). CONCLUSIONS: GDM pregnant women with SCH are more severely impaired in pancreatic islet function and have a higher probability of using insulin.